Incidence of prostate cancer in Sicily: Results of a multicenter case-findings protocol

Objective: To establish the incidence of prostate cancer (PCa) in Sicily in patients who entered an early detection protocol.Methods: From February 2002 to February 2004, 16,298 subjects aged 40–75 entered the protocol. Patients with suspicious DRE, PSA >10 ng/ml, PSA 2.5 ng/ml, from 2.6 to 4 ng/ml or from 4.1 to 10 ng/ml with F/T PSA of15%, 20% and 25% respectively underwent needle biopsy according to an extensive protocol.Results: 3266 patients were eligible for biopsy; PSA was 4 in 12.7% and 10 ng/ml in 63.9% of patients. A PCa was found in 1171 cases (36.9%) with a relationship between PCa incidence and PSA and age respectively (x2-test, p < 0.0001); 51.8% of patients with PCa had a PSA <10 and 8.8% a PSA <4 ng/ml; 49% were clinically staged as T1c. The estimated odds ratios for each age group showed increased risk for PCa in the fourth decade with PSA between 2.6 and 4 ng/ml (12.5 times higher) and in the fifth decade with PSA between 4.1 and 10 ng/ml (6.2 times higher).Conclusions: Age and serum PSA levels are the major risk factors for PCa. On their basis it is possible to modulate the most suitable timing for early diagnosis in individual patients.# 2004 Elsevier B.V. All rights reserved.