The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy
Transrectal ultrasound (TRUS)–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-g...
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/tsw.2009.47 |
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| author | Nadeem Shaida Catherine M. Jones Navin Ravindranath Peter R. Malone |
| author_facet | Nadeem Shaida Catherine M. Jones Navin Ravindranath Peter R. Malone |
| author_sort | Nadeem Shaida |
| collection | DOAJ |
| description | Transrectal ultrasound (TRUS)–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density (PSAD), PSA velocity (PSAV), prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 (16%) had a PSA >20 ng/ml, including 99 (26%) with benign biopsies. Of those, 67 were rebiopsied, including 19 (28%) with cancer on the first rebiopsy and four (6%) on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer (p <0.05). Patients who present with a PSA >20 ng/ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng/ml/cm3. |
| format | Article |
| id | doaj-art-066df24685b34cb0be12605a6681850e |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-066df24685b34cb0be12605a6681850e2025-02-03T01:21:31ZengWileyThe Scientific World Journal1537-744X2009-01-01934334810.1100/tsw.2009.47The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative BiopsyNadeem Shaida0Catherine M. Jones1Navin Ravindranath2Peter R. Malone3Harold Hopkins Department of Urology, Royal Berkshire Foundation NHS Trust, Reading, RG1 5AN, United KingdomHarold Hopkins Department of Urology, Royal Berkshire Foundation NHS Trust, Reading, RG1 5AN, United KingdomHarold Hopkins Department of Urology, Royal Berkshire Foundation NHS Trust, Reading, RG1 5AN, United KingdomHarold Hopkins Department of Urology, Royal Berkshire Foundation NHS Trust, Reading, RG1 5AN, United KingdomTransrectal ultrasound (TRUS)–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density (PSAD), PSA velocity (PSAV), prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 (16%) had a PSA >20 ng/ml, including 99 (26%) with benign biopsies. Of those, 67 were rebiopsied, including 19 (28%) with cancer on the first rebiopsy and four (6%) on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer (p <0.05). Patients who present with a PSA >20 ng/ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng/ml/cm3.http://dx.doi.org/10.1100/tsw.2009.47 |
| spellingShingle | Nadeem Shaida Catherine M. Jones Navin Ravindranath Peter R. Malone The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy The Scientific World Journal |
| title | The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy |
| title_full | The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy |
| title_fullStr | The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy |
| title_full_unstemmed | The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy |
| title_short | The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy |
| title_sort | chances of subsequent cancer detection in patients with a psa 20 ng ml and an initial negative biopsy |
| url | http://dx.doi.org/10.1100/tsw.2009.47 |
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