Background: Prostate cancer is the most common type of cancer among Nigerian men. Prostate specific antigen (PSA) is produced by the prostate gland and it is an important tumor marker in the screening and diagnosis of prostate cancer because the latter is often associated with elevated PSA levels. The aim of this study was to evaluate the profile and PSA levels of men presenting for prostate cancer screening at the National Obstetric Fistula Centre, Abakaliki, Nigeria. Methods: This was a retrospective study of 103 patients who were seen between January 2014 and December 2015 and screened for prostate cancer using PSA assay. Data was extracted from folders of patients using a proforma and analysed using the Statistical Package for Social Sciences (SPSS), version 21. Result: Out of the 103 clients studied, 67 (65%) were between the ages of 40 and 59 years. The mean age was 54.38 ± 12.5 years. Eighty-one (78.6%) of the study population had PSA levels 4 ng/ml and below, 5 (4.9%) had PSA levels of 4.1 - 10 ng/ml, while 17 (16.5%) had PSA levels > 10 ng/ml. The mean PSA was 4.75 ± 8.2 ng/ml. None of the patients with family history of cancer had PSA levels of >4 ng/ml. Those who were positive for HIV also had normal PSA results. Conclusion: The findings from this study showed that the prevalence of men with raised PSA (>4 ng/ml) was high (21.4%) especially in the 60 - 69 years age group. There is need to increase prostate cancer screening using PSA in our setting. The use of other parameters such as digital rectal examination, PSA density, PSA velocity and free PSA will be helpful to determine the need for histological diagnosis in these patients.
References
[1]
Ogunbiyi, J.O. and Shittu, O.B. (1999) Increased Incidence of Prostate Cancer in Nigerians. Journal of the National Medical Association, 91, 159-64.
[2]
Agnihotri, S., Mittal, R.D., Kapoor, R. and Mandhani, A. (2014) Raising the Cut-Off Value of Prostate Specific Antigen (PSA) for Biopsy in Asymptomatic Men in India to Reduce Unnecessary Biopsy. Indian J Med Res, 139, 851-856.
[3]
Shah, S.J., Goyal, V., Sachar, R., Nath, A. and Bajaniya, S. (2009) Early Detection of Prostate Cancer in Patients with PSA Levels of 2.5 to 4.0 Ng/ml. GMJ, 64, 10-12.
[4]
Hunter, C. and Zamiara, P. (2012) The Role of Prostate-Specific Antigen (PSA) Testing in Screening for Prostate Cancer. UWOMJ, 18, 17-18.
[5]
National Cancer Institute. Prostate-Specific Antigen Test.
http://www.cancer.gov/cancertopics/factsheet/detection/PSA
[6]
Abrahamsson, P., Crwaford, E.D., Lucia, M.S., Sakr, W. and Schalken, J. (2003) Prostate Cancer: Epidemiology and screening. Reviews in Urology, 5, S3-S9.
[7]
Draisma, G., Etzioni, R., Tsodikov, A., Mariotto, A., Wever, E., Gulati, R., et al. (2009) Lead Time and Overdiagnosis in Prostate-Specific Antigen Screening: Importance of Methods and Context. Journal of the National Cancer Institute, 101, 374-383. https://doi.org/10.1093/jnci/djp001
[8]
Qureshi, Z.P., Bennett, C., Hermanson, T., Horner, R., Haider, R., Lee, M., et al. (2015) The Ethical Dilemma Surrounding Prostate Specific Antigen (PSA) Screening. Journal of Clinical Research and Bioethics, 6, 1.
[9]
Erhabor, O., Zama, I., Mainasara, A.S., Shehu, R.A., Iwueke, I.P., Aghedo, F., et al. (2014) Prostate Specific Antigen (PSA) Screening among Apparently Healthy Men of African Decent in Sokoto, North Western Nigeria. International Blood Research & Reviews, 2, 37-47. https://doi.org/10.9734/IBRR/2014/6362
[10]
Ukoli, F., Osime, U., Akereyeni, F., Okunzuwa, O., Kittles, R. and Adams-Campbell, L. (2003) Prevalence of Elevated Prostate Specific Antigen in Rural Nigeria. International Journal of Urology, 10, 315-322.
https://doi.org/10.1046/j.1442-2042.2003.00633.x
[11]
Akinremi, T.O., Adeniyi, A., Olutunde, A., Oduniyi, A. and Ogo, C.N. (2014) Need for and Relevance of Prostate Cancer Screening in Nigeria. Ecancer, 8, 457.
[12]
Lan, S., Tsai, Y., Lin, Y. and Tzai, T. (2007) Diagnostic Performance of a Random versus Lesion-Directed Biopsy of the Prostate from Transrectal Ultrasound. Journal of Ultrasound in Medicine, 26, 11-17. https://doi.org/10.7863/jum.2007.26.1.11
[13]
Luboldt, H., Schindler, J.F. and Rubben, H. (2007) Age Specific Reference Ranges for Prostate-Specific antigen as a Marker for Prostate Cancer. EAU-EBU Update Series, 5, 38-48.
[14]
Adeloye, D., David, R.A., Aderemi, A.V., Iseolorunkanmi, A., Oyedokun, A., Iweala, E.E.J., et al. (2016) An Estimate of the Incidence of Prostate Cancer in Africa: A Systematic Review and Meta-Analysis. PLoS ONE, 11, e0153496.
https://doi.org/10.1371/journal.pone.0153496
[15]
Mejak, S.L., Bayliss, J. and Hanks, S.D. (2013) Long Distance Bicycle Riding Causes Prostate-Specific Antigen to Increase in Men Aged 50 Years and Over. PLoS ONE, 8, e56030. https://doi.org/10.1371/journal.pone.0056030
[16]
Kim, S., Jang, K., Park, W., Kwon, D., Kang, W. and Lim, H. (2014) Serum Prostate-Specific Antigen Levels and Type of Work in Tire Manufacturing Workers. Annals of Occupational and Environmental Medicine, 26, 50.
https://doi.org/10.1186/s40557-014-0050-z
[17]
Madersbacher, S., Alcaraz, A., Emberton, M., Hammerer, P., Ponholzer, A. and Schroder, F.H. (2011) The Influence of Family History on Prostate Cancer Risk: Implications for Clinical Management. BJU International, 107, 716-721.
https://doi.org/10.1111/j.1464-410X.2010.10024.x
[18]
Bratt, O., Drenn, L., Akre, O., Garmo, H. and Stattin, P. (2016) Family History and Probability of Prostate Cancer, Differentiated by Risk Category: A Nationwide Population Based Study. Journal of the National Cancer Institute, 108, djw110.
https://doi.org/10.1093/jnci/djw110
[19]
Cancer Genetics Editorial Board. PDQ Genetics of Prostate Cancer. National Cancer Institute, Bethesda, MD. http://www.cancer.gov/types
[20]
Silberstein, J.W., Downs, T., Lakin, C. and Kune, C.J. (2009) HIV and Prostate Cancer: A Systematic Review of the Literature. Prostate Cancer and Prostatic Diseases, 12, 6-12. https://doi.org/10.1038/pcan.2008.44
[21]
Marcus, J.L., Chao, C.R., Leyden, W.A., Xu, L., Klein, D.B., Horberg, M.A., et al. (2004) Prostate Cancer Incidence and Prostate Specific Antigen Testing among HIV Positive and HIV Negative Men. Journal of Acquired Immune Deficiency Syndromes, 66, 495-502. https://doi.org/10.1097/QAI.0000000000000202
[22]
Shiels, M.S., Goedert, J.J., Moore, R.D., Platz, E.A. and Engels, E.A. (2010) Reduced Risk of Prostate Cancer in US Men with AIDS. Cancer Epidemiology, Biomarkers & Prevention, 19, 2910-2915. https://doi.org/10.1158/1055-9965.EPI-10-0741
