Presentation Authors: Yongqiang Huang*, Chengyuan Gu, Xiaojian Qin, Yuanyuan Qu, Jianfeng Yang, Jing Hong, li Liu, Kefa Zheng, Lihua Xu, Huaiping Zhao, Xiongxion Qian, Dingwei Ye, Shanghai, China, People's Republic of
Introduction: There is marked regional differences in the prostate cancer (PCa) incidence and mortality rates rate between China and the West. The incidence of PCa is increasing rapidly in China, the clinical stage of PCa patients is comparatively late and the overall survival rate is inferior to that reported in the developed countries. Though population-based PSA screening still is controversially discussed in the West, it is an effective measure to reduce the risk of death through early detection. The Chinese Anti-Cancer Association Genitourinary Cancer Committee Prostate Cancer Screening Program is currently the largest ongoing screening program in China and aims to accrue 50,000 men within 5 yrs in a prospective fashion. The program started in June 2017.
Methods: According to Chinese consensus of prostate cancer screening, eligible men aged 50 with life expectancy over 10 years or aged 45 with high risk (e.g. those with a first degree relative diagnosed with PCa; age >40 yrs with baseline PSA â‰¥ 1.0 Î¼g/ml). The interviewer-administered questionnaire covered demographic characteristics and environmental exposure factors. Prostate-specific antigen (PSA) determination in serum with a cut-off of â‰¥4.0 ng/ml was the main screening test and indication for biopsy. The FRENDTM System is employed for a precise and rapid PSA detection. The Institutional Review Board of Fudan University Shanghai Cancer Center approved this study, and a written informed consent was obtained from all recruited individuals.
Results: 2, 162 men have been enrolled until October 2018. The median age was 70.0 yrs (45-85). Median PSA of theses participants was 1.21 ng/ml (range 0.01-25.0). Altogether, 11.0% (237 cases) had a confirmed PSA increase â‰¥ 4.0 ng/ml (median 9.1, range 4.0-25.0). Subsequently, 58 subjects (24.5%) out of the 237 PSA-suspicious men underwent prostate biopsy, and 38 were confirmed as PCa. Until now, the overall PCa incidence in the first screening round is 1.76%. We evaluated the associations between demographic, environmental exposure factors and PCa risk. Age (OR: 2.63; 95% CI: 1.84-3.75, P < 0.001), sleep hours (OR: 1.88; 95% CI: 1.37-2.58, P < 0.001) and chronic prostatitis history (OR: 2.02; 95% CI: 1.55-2.63, P < 0.001) were significantly associated with PSA level. After adjustment for these factors, older age (OR: 4.04; 95% CI: 1.71-9.59, P = 0.002) and no statins use (OR: 3.09; 95% CI: 1.25-7.69, P =0.015) were associated with an elevated risk of PCa.
Conclusions: Although largely underestimated, the incidence of PCa in the targeted Chinese population is higher than expected. Older men have a high risk of harboring PCa. Our study suggests a decreased risk of PCa in men with statins use.