Differences in Prostate Cancer between Korean Patients, the European Randomized Study of Screening for Prostate Cancer/Rotterdam Group, and a Dutch Clinical Cohort

ABSTRACT

PURPOSE: We evaluated differences in biopsy-detected prostate cancer (PC) between a newly defined Korean clinical cohort (KCC) and two Western populations. MATERIALS AND METHODS: The records of 723 Korean men aged 55 to 75 years who underwent an initial transrectal ultrasound-guided biopsy from 2004 to 2010 were retrospectively reviewed. Prostate biopsies were performed due to prostate-specific antigen (PSA) levels greater than 4.0ng/ml, or suspicious findings on rectal examination or transrectal ultrasonography. Characteristics of PC were compared between the KCC and Western groups (the Rotterdam group of the European Randomized Study of Screening for Prostate Cancer ERSPC and Dutch Clinical Cohort DCC). RESULTS: The cancer detection rate was 26.4% (191/723) in the KCC, 20.9% (473/2268) in the ERSPC/Rotterdam group and 43.1% (138/320) in the DCC. The median PSA in patients with PC was 11.8ng/ml, 5.7ng/ml and 7.5ng/ml in the KCC, ERSPC/Rotterdam group, and DCC, respectively. The proportion of patients with a Gleason score of 7 or more was 57.1% (109/191) in the KCC, 37.5% (174/464) in the ERSPC/Rotterdam group and 37.0% (51/138) in the DCC. CONCLUSIONS: We found large differences in cancer detection rate, PSA, and Gleason score distribution between the KCC and Western cohorts. PC detected in Korean patients had more advanced clinical factors than in Western populations due to low availability of PSA screening programs.