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Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia

Objectives: 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 initi...

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Main Authors: Yii, Raymond Shi Liang, Lim, Jasmine, Sothilingam, Selvalingam, Yeoh, Wei Sien, Fadzli, Ahmad Nazran, Ong, Teng Aik, Kuppusamy, Shanggar, Razack, Azad Hassan Abdul
Format: Article
Published: Elsevier 2020
Subjects:
R Medicine
Online Access:http://eprints.um.edu.my/24651/
https://doi.org/10.1016/j.asjsur.2019.02.014
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spelling my.um.eprints.246512020-06-04T03:39:16Z http://eprints.um.edu.my/24651/ Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia Yii, Raymond Shi Liang Lim, Jasmine Sothilingam, Selvalingam Yeoh, Wei Sien Fadzli, Ahmad Nazran Ong, Teng Aik Kuppusamy, Shanggar Razack, Azad Hassan Abdul R Medicine Objectives: 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. © 2019 Elsevier 2020 Article PeerReviewed Yii, Raymond Shi Liang and Lim, Jasmine and Sothilingam, Selvalingam and Yeoh, Wei Sien and Fadzli, Ahmad Nazran and Ong, Teng Aik and Kuppusamy, Shanggar and Razack, Azad Hassan Abdul (2020) Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia. Asian Journal of Surgery, 43 (1). pp. 87-94. ISSN 1015-9584 https://doi.org/10.1016/j.asjsur.2019.02.014 doi:10.1016/j.asjsur.2019.02.014
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Yii, Raymond Shi Liang
Lim, Jasmine
Sothilingam, Selvalingam
Yeoh, Wei Sien
Fadzli, Ahmad Nazran
Ong, Teng Aik
Kuppusamy, Shanggar
Razack, Azad Hassan Abdul
Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
description Objectives: 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. © 2019
format Article
author Yii, Raymond Shi Liang
Lim, Jasmine
Sothilingam, Selvalingam
Yeoh, Wei Sien
Fadzli, Ahmad Nazran
Ong, Teng Aik
Kuppusamy, Shanggar
Razack, Azad Hassan Abdul
author_facet Yii, Raymond Shi Liang
Lim, Jasmine
Sothilingam, Selvalingam
Yeoh, Wei Sien
Fadzli, Ahmad Nazran
Ong, Teng Aik
Kuppusamy, Shanggar
Razack, Azad Hassan Abdul
author_sort Yii, Raymond Shi Liang
title Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
title_short Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
title_full Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
title_fullStr Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
title_full_unstemmed Predictive factors of prostate cancer diagnosis with PSA 4.0–10.0 ng/ml in a multi-ethnic Asian population, Malaysia
title_sort predictive factors of prostate cancer diagnosis with psa 4.0–10.0 ng/ml in a multi-ethnic asian population, malaysia
publisher Elsevier
publishDate 2020
url http://eprints.um.edu.my/24651/
https://doi.org/10.1016/j.asjsur.2019.02.014
_version_ 1669008008906014720
score 13.211869

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