Characteristics of prostate cancer by opportunistic screening in Korean men with a prostate-specific antigen level less than 4.0 ng per milliliter

Hoon Choi, Seok Cho, Jae Hyun Bae, Sang Eun Lee, Sung Kyu Hong, Du Geon Moon, Jun Cheon, Seok Soo Byun, Jae Young Park

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Background/Aims/Objectives: We studied the detection rate of prostate cancer (PCa) among Korean men with a prostate-specific antigen (PSA) level of less than 4.0 ng/mL. Methods: A total of 1,680 men with PSA ≤4 ng/mL had a prostate biopsy from January 2004 to December 2014. The differences in clinical factors were analyzed and their independent predictive implications were evaluated. Results: PCa was diagnosed in 331 (19.6%) and 99 of these 331 cancers (14.9%) had a Gleason score of 7 or higher. The detection rate of PCa increased from 6.67% (≤0.5 ng/mL) to 20.36% (3.01-3.9 ng/mL). There were significant differences in age 65.7 vs. 62.1 years, prostate volume 33.4 vs. 38.2 g, PSA density 0.10 vs. 0.08 ng/mL/mL between men with and without PCa. On multivariable analysis, age and prostate volume were the best independent discriminative parameters. When comparing PCa patients with a Gleason score less than 6 to those with a 7 or higher, patients with a Gleason score 7 or higher were older (67.2 vs. 64.8 years). Conclusions: Even when the PSA level is less than 4 ng/mL, PCas, including high-grade cancers, were detected in a significant number of men. In this group, patients with PCa were older and had a smaller prostate volume and high-grade cancers were detected more frequently in older cancer patients.

Original languageEnglish
Pages (from-to)143-148
Number of pages6
JournalUrologia Internationalis
Issue number2
Publication statusPublished - 2017 Sep 1



  • Biopsy
  • Prostate cancer
  • Prostate-specific antigen

ASJC Scopus subject areas

  • Urology

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