PSA Pattern in Saudi Population KFSH&RC Jeddah

Anmar Nassir, Assistant Prof, Um Al-Qura Univ

Hasan Farsi, Prof, KAUH

Ammar Dehlawi, Teach assist Um Al-Qura Univ

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.

Our aim is : to identify the pattern of PSA values in our

population. to identify the high risk patients: candidate for

TRUS biopsy

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

The overall average age 63.8 (+/- 11.8 SD).

A total of 4210 specimen of PSA were analyzed for 2181 patients.

PSA ng/ml< 2.5< 4 4-10 >10

% of pt

Free to total PSA ratio for PSA of 4-10

< 11 < 18 < 22 < 25

no.

%

For pts between 4-10 % according to cut points

PSA velocity was studied in 2803 PSA samples for 801 patients, with an average of 3.5 samples for each

patient.

Patients PSA progression

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%

In the western region: Out of 45 patients underwent TRUS

guided biopsy; cancer of the prostate was detected in 13 (28.8%).

7.6% in patients presented with abnormal DRE alone

15.3% in the group with elevated PSA but normal DRE (stage T1c).

21.4% PSA was elevated to 4-10 ng/ml

40% PSA to10-20 ng/ml 100% PSA > 20 ng/ml

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

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

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

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

At KFSH & RC Jd 88 patients came back +ve for Prostate cancer.

84/2181 = 4%

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

By non By urologist

age

SD

No. %

< 4

4-10

> 10

> 20

PSA By non Urologists by Urologists

# % # %

< 4

4-10

> 10

> 20

All patients Patients to FM From out side

PSA no. % no. % No. %

< 4

4 to < 10

> or = 10

> or = 20