PSA Pattern in Saudi Population KFSH&RC Jeddah
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Anmar Nassir, Assistant Prof, Um Al-Qura Univ
Hasan Farsi, Prof, KAUH
Ammar Dehlawi, Teach assist Um Al-Qura Univ
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Little is known about prostate cancer in Saudi Arabia.
National Cancer Registry data GU Ca: 9.2% in KSA, vs 24.1% USA Prostatic CA is X 50 lower than in USA The most common GU CA in KSA is
bladder, followed by the prostate, kidney, and testicular cancer.
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Our aim is : to identify the pattern of PSA values in our
population. to identify the high risk patients: candidate for
TRUS biopsy
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Between October 2002 and November 2007, all PSA values ordered at KFSH& RC in Jeddah were studied.
Data collected: patient's age, total PSA, free to total ratio, PSA velocity
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The overall average age 63.8 (+/- 11.8 SD).
A total of 4210 specimen of PSA were analyzed for 2181 patients.
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PSA ng/ml< 2.5< 4 4-10 >10
% of pt
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Free to total PSA ratio for PSA of 4-10
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< 11 < 18 < 22 < 25
no.
%
For pts between 4-10 % according to cut points
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PSA velocity was studied in 2803 PSA samples for 801 patients, with an average of 3.5 samples for each
patient.
Patients PSA progression
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In the Eastern region of SA: PSA screening of 1192 6.9 % indicated for TRUS Bx Only 75 % agreed for Bx CA in 14 only = 1.17%
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In the western region: Out of 45 patients underwent TRUS
guided biopsy; cancer of the prostate was detected in 13 (28.8%).
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7.6% in patients presented with abnormal DRE alone
15.3% in the group with elevated PSA but normal DRE (stage T1c).
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21.4% PSA was elevated to 4-10 ng/ml
40% PSA to10-20 ng/ml 100% PSA > 20 ng/ml
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21.4% PSA was elevated to 4-10 ng/ml 40% PSA to10-20 ng/ml 100% PSA > 20 ng/ml
% of CA-- 1.64 % 2.44 %
PSA ng/ml< 2.5< 4 4-10 >10
% of pt76.8858.26.1
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All patients Patients to FM
PSA no. % no. %
< 4 1871 86% 162 87.5
4 to < 10 178 8.20% 12 6.5
> or = 10 132 6.05% 11 5.9
2181 100% 185 99.9
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Sensitivity of CA detection: PSA between 4-10 vs <4 ng/mL:
79% for levels between 4 and 10 ng/mL. 11% at levels below 4 ng/mL
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In a large prospective screening study 47% among men with a PSA velocity >
0.75 ng/mL per year 11% among men with a PSA velocity <
0.75 ng/mL per year
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At KFSH & RC Jd 88 patients came back +ve for Prostate cancer.
84/2181 = 4%
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عن معاذ بن جبل ، أنهم خرجوا مع رسول الله صلى الله عليه وآله ... وسلم عام تبوك
إنكم ستأتون غدا ، إن شاء الله عين تبوك ، وإنكم لن تأتوها قال: "حتى يضحى النهار ، فمن جاءها فال يمس من مائها شيئا حتى
“آتيفجئناها ، وقد سبقنا إليها رجالن ، والعين تبض بشيء من ماء،
هل مسستما من مائها شيئا؟فسألهما رسول الله:" " . فقاال : نعم
. قال لهما ما شاء الله أن يقول...ثم غرفوا بأيديهم من العين ، قليال قليال . حتى اجتمع في شيء ، ثم غسل رسول الله صلى الله عليه وسلم ، فيه وجهه
ويديه . ثم أعاده فيها ، فجرت العين بماء كثير . . فاستقى الناس
يوشك يا معاذ إن ثم قال رسول الله صلى الله عليه وسلم : " ” طالت بك حياة، أن ترى ما هاهنا قد ملئ جنانا
واإلمام مسلم في صحيحه 331مالك في الموطأ 4327
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By non By urologist
age
SD
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No. %
< 4
4-10
> 10
> 20
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PSA By non Urologists by Urologists
# % # %
< 4
4-10
> 10
> 20
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All patients Patients to FM From out side
PSA no. % no. % No. %
< 4
4 to < 10
> or = 10
> or = 20