Background: We evaluated the characteristic differences of biopsy-detected prostate cancer (PC) between Korean clinical cohort (KCC) and Western population including European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam group and Dutch clinical cohort (DCC).
Methods: The data of 723 Korean men aged from 55 to 75 years who underwent initial transrectal ultrasound-guided biopsy were retrospectively reviewed. Prostate biopsy was performed due to prostate-specific antigen (PSA) greater than 4.0 ng/ml, suspicious findings in rectal examination or transrectal ultrasonography. These data were compared with data from Western group.
Results: The median age was 66, 66 and 65 years in KCC, ERSPC, Rotterdam group, and DCC, respectively. Cancer detection rate was 26.4% (191/723) in KCC, 20.9% (473/2268) in ERSPC, Rotterdam group and 43.1% (138/320) in DCC. The median PSA in patient with PC was 11.8 ng/mL, 5.7 ng/mL and 7.5 ng/mL in KCC, ERSPC, Rotterdam group, and DCC, respectively. Among the patients with PC, PSA levels in Koreans were significantly higher than those of ERSPC, Rotterdam group and those of Dutch clinical cohort. The proportion of Gleason score 7 or more was 57.1% (109/191) in KCC, while 37.5% (174/464) in ERSPC, Rotterdam group and 37.0% (51/138) in DCC.
Conclusions: The remarkable differences of characteristics were noted in cancer detection rate, PSA, and Gleason score distribution. These differences indicate that Korean patients with PC seem to be detected in more advanced state than Western group due to low availability of PSA screening program.