At Bugando Medical Centre, prostate cancer contributes to 39% of all cancers in male patients admitted to the Oncology department, and the majority have high Gleason grades. Although Prostate-specific antigen density (PSAD) has been shown to improve the diagnostic accuracy of prostate cancer and to triage patients for prostate biopsy, there is a significant variation across geographical locations. A hospital-based cross-sectional study among patients with prostate-related urinary symptoms at Bugando Medical Centre, Mwanza, Tanzania. The study analyzed prostate-specific antigen levels, prostate volume, and total PSA using Maglumi 2000 and a computer system. Histopathological examination involved transrectal biopsy, TURP, and open prostatectomy. The optimal cutoff for PSA density was determined using the receiver operating characteristic curve. Of the 287 patients, the overall mean age of 71.2 (± 10.2) years. 99 (34.5%) participants were diagnosed with prostate cancer. The area under the curve for prostate-specific antigen density and PSA was 0.9094 (0.8761–0.9426) and 0.8932 (0.8569–0.9295), respectively. The PSAD optimal cut-off was 0.23ng/ml2, giving sensitivity of 86.9% and specificity of 82.4% for prostate cancer prediction. Using this cutoff reduces prostate biopsies by 54.5%. There was a weak positive correlation (Spearman’s rho (ρ) = 0.2456) between prostate-specific antigen density and Gleason grade groups. The correlation between PSAD and Gleason grade groups observed in this study suggests that higher PSAD is associated with more aggressive cancer. This makes PSAD a valuable tool in guiding biopsy decisions, risk stratification, and treatment planning in patients with prostate-related urinary symptoms.
Jackson et al. (Thu,) studied this question.