Prostate-specific antigen density in prostate cancer screening in diabetes mellitus patients

Abstract

Objectives: The purpose of this study was to examine the function of prostate-specific antigen (PSA) and prostate-specific antigen density (PSAd) in the screening of prostate cancer in individuals with Diabetes Mellitus (DM).

Methods: This study was retrospective and cross-sectional. 467 patients who underwent transrectal ultrasound-guided 10-12 core prostate biopsy between 01 January and 31 December 2022 were included. Through the hospital information management system, the demographics, radiological, biochemical, and pathological results of the patients were scanned.

Results: PSAd>0.15 ng/mL/cm³ and total PSA (t-PSA)>8.58 ng/mL were substantially associated with an elevated probability of the existence of cancer when all patients were included. PSAd>0.19 ng/mL/cm³ and t-PSA>11.34 ng/mL were shown to be strongly associated with an elevated risk of cancer in patients with DM (P<0.001). PSAd>0.14 ng/mL/cm³ and t-PSA>8.49 ng/mL were substantially associated with an elevated probability of cancer presence in individuals without a diagnosis of DM. PSAd>0.15 ng/mL/cm³ and t-PSA>8.58 ng/mL were substantially associated with an elevated probability of cancer presence in individuals with fasting blood glucose (FBG) <126 mg/dL (P<0.001). It has been established that PSAd cannot be utilized as a marker to predict cancer in people with FBG≥126 mg/dL (P=0.070). Higher cancer risk was substantially correlated with t-PSA values of >5.73 ng/mL (P=0.001).

Conclusions: The change in prostate volume brought on by high blood glucose levels might be the cause of PSAd's lack of selectivity. Patients with DM are a special group in prostate cancer screening, and this should be considered when establishing cancer screening algorithms.

Keywords

• Prostate-specific antigen (PSA)
• PSA density
• prostate cancer
• diabetes mellitus
• risk estimation

References

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