Prevalentie van prostaatkanker gelijk bij mannen van 50 jaar of ouder met en zonder mictieklachten

To determine the prevalence of prostate cancer and its relation to lower urinary tract symptoms (LUTS) in a population-based study of men aged 50 years and over.

Design

Cross-sectional study.

Method

A group of 1688 men, aged 50-78 years, resident in Krimpen aan den IJssel, the Netherlands, was investigated by means of self-administered questionnaires and measurements at a health centre and a urology outpatient department. The study population represented a 50 response to an invitation to participate. This was issued to all male residents in the age range concerned, excluding men with a history of radical prostatectomy, neurogenic bladder disease, previous bladder or prostate cancer, inability to fill in questionnaires or to visit a health centre, or a negative advice from the general practitioner regarding participation. Prostate biopsies were taken according to a described protocol, independently of the presence or severity of LUTS, based on the serum prostate specific antigen (PSA) level, the results of digital rectal examination and the findings on transrectal ultrasonography of the prostate.

Results

According to the protocol, 182 biopsies were advised, of which 173 actually were performed. In these biopsies, 58 prostate cancers were detected (prevalence 3.6). The prevalence increased sharply in the higher age groups, but was not related to the presence or severity of LUTS (3.3 in men without LUTS or with mild symptoms vs. 3.7 in men with moderate to severe LUTS; chi-square test; p = 0.686). Tumour stage and grade did not differ between age groups or between men with moderate to severe LUTS and those without LUTS or with mild symptoms.

Conclusion

The prevalence of prostate cancer was equal among older men with and without LUTS. Performing a PSA-test based only on the presence of LUTS is equivalent to screening unselected men. The value of such screening is as yet unknown.