892 Prostate Specific Antigen Density (PSAD) in predicting prostate cancer: A District General Hospital Analysis

Abstract Aim PSAD is a marker to predict prostate cancer with levels 0.15 ng/ml2 increasing the chances of prostate cancer. This study aims to investigate the use of PSAD in predicting patients with prostate cancer. Method A retrospective audit of patients who underwent LATP under one urologist over a 10-month period (11/2/2022-27/11/2022) were included in the study. Data of PSA levels, LATP histology findings, MP-MRI results and cancer MDT notes were found from the online record system and recorded. Results A total of 53 male patients underwent LATP over the 10-month period. The mean age of patients was 71.6 years old. 77.4% (41) patients were diagnosed with prostate adenocarcinoma, 18.9% (10) had benign histology, and 2 patients showed high-grade prostate intraepithelial neoplasia (PIN). The median PSA value for patients with adenocarcinoma is 9.3ng/ml (4.8-300.9). For patients with a PSAD of 0.15 ng/ml2, 78% (32) of patients had adenocarcinoma, 20% (2/10) patients had benign histology, and 50% (1/2) patients had high-grade PIN. With a PSAD 0.10 ng/ml2, there was a 92.7% sensitivity and 33.3% specificity in detecting prostate cancer. Conclusion PSAD 0.15ng/ml2 is a good marker in predicting prostate cancer, however, other investigations such as MP-MRI and prostate biopsy should be used to facilitate the diagnosis. A lower PSAD value will increase the sensitivity but reduce the specificity, leading to unnecessary prostate biopsies. Further studies with larger sample size and that compares various PSAD cut-off with prostate cancer should be conducted.