Association Between Prostate Cancer Detection Rate and Year of Prostate Biopsy

TL;DR

The study found that prostate cancer detection rates increased over time in South Korea, especially in older patients with higher PSA levels and more severe cancer grades.

Contribution

This study demonstrates a significant and consistent increase in prostate cancer detection rates with the year of biopsy, adjusted for clinical factors.

Findings

Prostate cancer detection rates increased from 24.8% to 48.9% between 2008 and 2022.

Higher detection rates were observed in patients with higher PSA levels and higher ISUP grade groups.

The detection rate increase was significant for ISUP grade groups 2–3 and 4–5 but not for grade group 1.

Abstract

As the prostate cancer (PCa) detection rate in South Korea is increasing year by year, authors investigated whether there was a plausible relationship between the year the prostate biopsy (PBx) was performed and the PCa detection rate. The medical records of 1628 patients who underwent PBx between 2008 and 2022, for each even-numbered year, were retrospectively reviewed. The primary outcome was the PCa detection rate, and the secondary outcome was to determine whether the PCa detection rate was significantly associated with the year of PBx and other clinical factors. When comparing baseline clinical factors among PBx patients by year, there were significant differences in age at the time of PBx (p = 0.017) and the number of PBx cores (p < 0.001). PCa detection rates ranged from 24.8% to 48.9% and were significantly positively correlated with the year of PBx (R2 = 0.885, p < 0.001). Subgroup analysis according to the prostate-specific antigen (PSA) level (≤10, over 10 to 20, >20 ng/mL) showed detection rates of 13.5–40.9%, 29.2–62.2%, and 73.3–92.6%, respectively (p < 0.001–0.021). Subgroup analysis according to the International Society of Urological Pathology grade group (ISUP GG) (1, 2–3, 4–5) showed that the PCa detection rate increased significantly over time in two subgroups (2–3: 4.8→16.7%, 4–5: 10.4→18.9%, all p = 0.002) except in the ISUP GG 1 subgroup. The PCa detection rate tends to increase with each successive biennial year of PBx. This increasing trend seems to be particularly pronounced in patients with relatively older age, higher PSA, and higher ISUP GG.

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