Reliability of Prostatic Specific Antigen in Detection of Prostatic Cancer Among Arab Population

This study was conducted on 652 patients, who attended the Urology Clinic at Dr. Fakhry Hospital, Eastern Province, K.S.A. between January, 2001 and December, 2003. All Patients were subjected to digital rectal examination as well as estimation of total serum prostatic specific antigen (PSA). They were classified into 3 groups according to the level of PSA which include GI: with level of 0-4 ng/ml (78%), GIl: with level of 4-10ng/ml (14%) and GIll: with level of 10ng/ml (8% ). By histolopathological study, the incidence of prostatic cancer was significantly increased in GIII ( 16. 7%) with higher levels of PSA compared to GII cases (2.8%) with p-valve of 4.219; however, this incidence was much lower than that reported in previous foreign reports. Regarding the other prostatic diseases, non-significant differences were detected between the 2 groups. Total PSA and f/tPSA ratio showed highly significant differences in patients with histologically confirmed prostatic cancer compared to those cases without cancer, but PSA-density didn t express a significant difference between these two patient s categories. Conclusion: A lower rate of prostate cancer in the Arab countries was detected compared to Europe and USA and so, prostate volume and inflammation were the most important factors contributing to serum PSA elevation without clinically detectable prostatic cancer. Finally, PSA was found to be a good biochemical marker for follow-up of the disease progression, response to therapy and detection of the early recurrences.