Evaluation of Prostate CancerDetection Rates in PatientsUndergoing TransrectalUltrasound (TRUS) GuidedProstate Biopsy

Background: Prostate cancer is one of the most common types of organ cancer among males in Turkey as well as all over the world. The gold standard method for histopathological diagnosis of prostate cancer is Trans rectal Ultrasound (TRUS)-guided prostate biopsy. Today, the most common indications for prostate biopsy are suspicious findings on digital rectal examination and increased serum Prostate Specific Antigen (PSA) level. Although there is no generally accepted guideline regarding the preparation and performing prostate biopsies, it has been reported that prostate cancer is detected at different frequencies with different techniques. In this study, we aimed to investigate the frequency of prostate cancer detected in patients undergoing TRUS-guided prostate biopsy and its relationship with patient characteristics and technique. Material and methods: Patients, who had undergone TRUSguided prostate biopsy between January 2003 and December 2007 at the Urology Department of Mersin University Faculty of Medicine, were enrolled in the study. All patients were standardly prepared before the biopsy and at least 12 pieces of biopsy specimens were obtained during the procedure. Results: A total of 906 biopsies were performed in 832 patients. The mean age of the patients was 67.2±8.7 years. Sixty-two patients (6.8%) had undergone biopsy two-times and 12 patients (1.3%) had undergone the procedure 3-times. Prostate cancer detection rates were 29.4% in first biopsies and 12.9% in second biopsies. No cancer was detected in any of the patients who had undergone the third prostate biopsy. When evaluated according to years, the prostate cancer detection rates were found to be 16.5%, 30.2%, 25.1%, 31% and 30.1% from 2003 to 2007, respectively. Prostate cancer rates were 19% and 8.6% in patients with normal (n = 573) and suspicious (n = 259) digital rectal examination findings. When the rates of prostate cancer according to PSA values were evaluated, the prostate cancer rates in patients with serum PSA <4 ng / ml, 4-10 ng / ml and > 10 ng / ml were found to be 4.8%, 17.9% and 47%, respectively. Conclusion: Prostate cancer, the rate of which has increased in recent years, responds very well to treatment when diagnosed early. Our findings, in particular, the frequent use of PSA and advances in biopsy techniques have been shown to be important factors in the increase in prostate cancer detection rates. Our findings show that a number of factors, especially more frequent measurement of PSA and improvements in biopsy techniques play important roles in the increase in prostate cancer detection rates.