The prevalence of prostate cancer in men undergoing finger guided prostate biopsy at the university teaching hospital in Lusaka,Zambia

Abstract

Prostate cancer is the most common malignancy in men other than Skin cancer worldwide. In Zambia a review of histological reports showed that prostate cancer is the most common urological malignancy. Recent studies have shown that there is a high prevalence of this cancer in Africa where the population is predominantly black. From literature a lot of studies have reported a range of 30% to 60% prostate cancer detection rate in men undergoing finger guided prostate biopsies around the world. This study was undertaken to determine the prevalence and Characteristics of prostate cancer in men undergoing prostate biopsy at the University Teaching Hospital in Lusaka Zambia. A prospective Cross Sectional Study was done at the UTH from April, 2014 to December, 2014 after getting ethical approval from UNZABREC. Patients undergoing prostate biopsy were recruited. A researcher administered Questionnaire was used to collect data on demographic details, Clinical presentation, Indication for biopsy and Prostate specific Antigen (PSA) test result. Then a finger guided, 6 core transrectal prostate biopsies were performed by experienced Urologists. The histological samples were analysed by pathologists at the UTH and other private laboratories. The obtained Data was analyzed using SPSS A total of 146 men undergoing prostate biopsy were recruited in the study. The age range was 49 to 92 years and the Mean age was 71.57. The most common symptoms were Lower Urinary tract symptoms at 89% in all patients and only 4.3% of men came asymptomatic.56% of the patients had a suspicious DRE finding. The PSA values ranged from 2.69 to 5480ng/ml. Most patients had serum PSA more than 20ng/ml. Prostate cancer (Adenocarcinoma) was found in 61 % (89/146) and Benign prostatic hyperplasia was found in 31.4%. Chronic prostatitis was found in 5.8%. The low risk cancer with Gleason score of 2 to 6 was found in 11.9%. The intermediate risk cancer with Gleason score 7 was found in 44% while the high risk cancer was also 44%. The prevalence of prostate cancer in men undergoing prostate biopsy at UTH was 61% and 44% of men had high risk cancers which are more aggressive with an unfavorable prognosis. Key words: Prostate cancer, finger guided prostate biopsy, Adenocarcinoma, Benign Prostatic hyperplasia, Chronic prostatitis, Gleason score,