20 research outputs found
Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
No full textPredictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
No full textObjectives: To identify the associated factors determining prostate cancer detection using transrectal ultrasound (TRUS)-guided prostate biopsy, within a multi-ethnic Malaysian population with prostate specific antigen (PSA) between 4.0 and 10.0 ng/ml. Methods: Study subjects included men with initial PSA between 4.0 and 10.0 ng/ml that have undergone 12-core TRUS-guided prostate biopsy between 2009 and 2016. The prostate cancer detection rate was calculated, while potential factors associated with detection were investigated via univariable and multivariable analysis. Results: A total of 617 men from a multi-ethnic background encompassing Chinese (63.5%), Malay (23.1%) and Indian (13.3%) were studied. The overall cancer detection rate was 14.3% (88/617), which included cancers detected at biopsy 1 (first biopsy), biopsy 2 (second biopsy with previous negative biopsy) and biopsy ≥ 3 (third or more biopsies with prior negative biopsies). Indian men displayed higher detection rate (23.2%) and increased risk of prostate cancer development (OR 1.85, 95% CI 1.03–3.32, p < 0.05), compared to their Malay (9.8%) and Chinese (14.0%) counterparts. Multivariable analysis revealed that ethnicity and PSA density (PSAD) are independent factors associated with overall prostate cancer detection rate. A unit increase of PSAD reflected an increase in PSA after controlling for prostate volume. Conclusion: Prostate cancer detection in Malaysia is comparatively lower. Our study suggests that ethnicity and PSA density should be considered when recommending first or repeat TRUS-guided prostate biopsy for prostate cancer detection in a multi-ethnic Malaysian population. © 201
Cardiovascular risk factors and ethnicity are independent factors associated with lower urinary tract symptoms
No full textObjectives: To determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting. Materials and Methods: We conducted a cross-sectional study of 1021 men aged 40-79 years with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses. Results: There were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p < 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity. Conclusion: Severity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS
Ethnicity is an independent determinant of age-specific PSA level: Findings from a multiethnic Asian setting
No full textObjectives: To study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting. Materials and Methods: We conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis. Results: There were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (≤4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (
A Novel Calculator for Estimating Prostate Volume in Daily Urology Services
No full textObjectives: To develop a simple prostate volume (PV) calculator that can aid in managing patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement at daily urology services in developing Asian countries. Materials and Methods: We conducted a cross-sectional study of men aged above 40 years with no history of prostate cancer, prostate surgery, or 5α-reductase inhibitor treatment. Serum prostate-specific antigen (PSA) and total PV were measured in each subject. Potential sociodemographic and clinical variables including age, weight, comorbidities, and International Prostate Symptom Score (IPSS) were collected. Of 1034 subjects, 837 were used in building the PV calculator using regression analysis. The remaining 1/5 (n = 197) was used for model validation. Results: There were 1034 multiethnic Asian men (Chinese 52.9%, Malay 35.4%, and Indian 11.7%) with mean age of 60 ± 7.6 years. Average PV was 29.4 ± 13.0 mL while the overall mean of PSA was 1.7 ± 1.7 ng/mL. We identified age, IPSS, weight, and PSA (all P <.05) in the PV regression model. Using the validation set, the coefficient of determination (R2) of this PV calculator was 0.47 where PV = 20.6 + (age − 60) × 0.1 + (IPSS score) × 0.1 + (Weight − 70) × 0.3 + (history of alpha-blocker treatment for LUTS) × 9.6 + PSA × 3.7. The area under curve of this model in predicting PV above 30 mL and 40 mL were 0.82 (95% confidence interval, 0.75-0.88) and 0.91 (95% confidence interval, 0.87-0.96), respectively. Conclusion: We develop a PV calculator that is simple and accurate to be used in routine clinical consultation for patients with LUTS. A separate study is important to confirm and to validate the findings in other populations
The comparison of prostate volume and PSA density between the Asian and Western population across various age groups.
No full text<p>The comparison of prostate volume and PSA density between the Asian and Western population across various age groups.</p
The median serum PSA concentration of the Asian and Western population across different age groups.
No full text†<p>Only 95<sup>th</sup> percentile was documented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0104917#pone.0104917-He1" target="_blank">[19]</a>.</p
Comparison of factors associated with LUTS.
No full text<p>Abbreviations: CI, confidence interval; IPSS, international prostate symptom score; LUTS, lower urinary tract voding symptoms; OR, odds ratio.</p><p>Comparison of factors associated with LUTS.</p
Comparison of factors associated with median PSA level.
No full text†<p>Based on the study population, the age-specific median PSA level was defined as 0.69 ng/ml, 0.93 ng/ml, 1.21 ng/ml and 1.52 ng/ml for the age groups of 40–49 years, 50–59 years, 60–69 years and 70–79 years, respectively. Abbreviations: CI, confidence interval; DRE, digital rectal examination; IPSS, international prostate symptom score; LUTS, lower urinary tract voding symptoms; OR, odds ratio; PC, prostate cancer.</p><p>*Percentage of subjects with missing values on height (0.5%), weight (0.4%), LUTS (2.9%), DRE (2.8%) and prostate volume (25.2%).</p
