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245 Stage distribution of prostate cancer at a tertiary care oncology centre in India : reflections of an unscreened population

In European Urology
By: Prakash G.
Contributor(s): Bakshi G | Shinde R | Bhamre R | Murthy V | Rent E | Pal M | Mahantshetty U | Menon S.
Material type: materialTypeLabelArticlePublisher: Amsterdam : Elsevier Science 2017Description: .Subject(s): Prostate cancer | Tertiary careOnline resources: PDF In: European Urology Vol. 16, no.3, p. e426Summary: INTRODUCTION & OBJECTIVES: To determine the stage distribution of patients diagnosed with prostate cancer in an unscreened population and provide a baseline for comparison with a screened population to analyse the impact of screening on stage of disease. MATERIAL & METHODS: We did a retrospective analysis of all treatment naive patients who presented to our centre with prostate cancer over a period of three years. We assessed the age and stage at presentation of these patients. The stage at diagnoses at our centre was compared with the western studies conducted in screened populations. RESULTS: Amongst the 1026 newly diagnosed prostate cancer patients registered at our hospital, disease was localised to the prostate in 269 (26.22%) patients, locally advanced (T3b,T4 or regional node involvement) in 134 (13.06%) and metastatic in 623 (60.72%) patients. 225 (21.9%) had isolated skeletal metastases, 39 (3.8%) patients had only non regional nodal metastases and 111 (10.8%) patients had isolated visceral metastases.The remaining 248 patients had a combination of two or more of these sites of metastases. Only 38 (3.7%) patients were less than 50 years of age and 353 (34.4%) patients were more than 70 years old. Median age of presentation was 66 years. Younger patients had disease of a higher gleason score. The overall incidence of metastatic disease in our unscreened population (60.7%) was drastically different from those reported in the two major trials representing a screened population (2.6% in the PLCO and 5.7% in the ERSPC trial). CONCLUSIONS: With concerns of overdiagnosis, overtreatment and small to no reduction in prostate cancer mortality, there are recommendations against screening in the western countries. However, complete absence of screening could result in significant stage migration at presentation as seen in our population. There is a need to bridge the gap created by undesirable consequences of both presence and absence of prostate cancer screening.
TMC TMH SO-Urology
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Articles Articles Tata Memorial Hospital
Available AR18282

Published in 32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

INTRODUCTION & OBJECTIVES: To determine the stage distribution of patients diagnosed with
prostate cancer in an unscreened population and provide a baseline for comparison with a screened
population to analyse the impact of screening on stage of disease.
MATERIAL & METHODS: We did a retrospective analysis of all treatment naive patients who presented
to our centre with prostate cancer over a period of three years. We assessed the age and stage at
presentation of these patients. The stage at diagnoses at our centre was compared with the western
studies conducted in screened populations.
RESULTS: Amongst the 1026 newly diagnosed prostate cancer patients registered at our hospital,
disease was localised to the prostate in 269 (26.22%) patients, locally advanced (T3b,T4 or regional
node involvement) in 134 (13.06%) and metastatic in 623 (60.72%) patients. 225 (21.9%) had isolated
skeletal metastases, 39 (3.8%) patients had only non regional nodal metastases and 111 (10.8%)
patients had isolated visceral metastases.The remaining 248 patients had a combination of two or more
of these sites of metastases. Only 38 (3.7%) patients were less than 50 years of age and 353 (34.4%)
patients were more than 70 years old. Median age of presentation was 66 years. Younger patients had
disease of a higher gleason score. The overall incidence of metastatic disease in our unscreened
population (60.7%) was drastically different from those reported in the two major trials representing a
screened population (2.6% in the PLCO and 5.7% in the ERSPC trial).
CONCLUSIONS: With concerns of overdiagnosis, overtreatment and small to no reduction in prostate
cancer mortality, there are recommendations against screening in the western countries. However,
complete absence of screening could result in significant stage migration at presentation as seen in our
population. There is a need to bridge the gap created by undesirable consequences of both presence
and absence of prostate cancer screening.

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