Cent Eur J Public Health 2020, 28(1):65-69 | DOI: 10.21101/cejph.a5720

Epidemiological study on more accurate diagnosis of prostate cancer

Josef Kopecký¹, Veronika Navláčilová², Jana Janoutová³, Vladimír Janout³

¹ Urology Department, Havířov Hospital, Havířov, Czech Republic

² Medihope Ltd., Olomouc, Czech Republic

³ Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic

Objective: The study aimed at assessing the potential benefit of prostate health index (PHI) for early detection of prostate cancer (PCa) and the use of PHI as a marker predicting the presence of PCa before performing prostate biopsy.

Methods: The study comprised 55 males who underwent prostate biopsy. Before the procedure, blood samples were collected to test prostate specific antigen (PSA) and free/total PSA ratio (%fPSA) and PHI was calculated. Receiver operating characteristic (ROC) analysis was used to assess the benefit of these values for predicting the presence of PCa.

Results: Based on histological examination 31 males were diagnosed with PCa, the remaining 24 were negative. Among the PCa patients, 39% had a Gleason score of 6, 26% had a score of 7 and 35% had a score of 8-10. There were statistically significant differences in PHI and PSA between males with and without PCa. The areas under the ROC curve for %fPSA, total PSA and PHI were 0.712, 0.746 and 0.789, respectively. PHI showed the best predictive ability to estimate biopsy results. If the cut-off criterion PHI > 36.4 (77.42% sensitivity, 66.67% specificity) had been used, 41.7% of males would have avoided unnecessary biopsy.

Conclusion: The use of PHI may considerably improve the accuracy of PCa detection in patients with elevated PSA and thus reduce the number of unnecessary biopsies.

Keywords: prostate cancer, prostate specific antigen, prostate health index, biopsy

Received: February 20, 2019; Revised: October 17, 2019; Accepted: October 17, 2019; Published: March 30, 2020  Show citation