[Early detection of prostate cancer-results of a prostate specific antigen-based detection program at a "multiphasic screening"]

Public awareness and knowledge of prostate cancer in Japan: results of a survey at short-stay examination facilities

BACKGROUND

This study was undertaken to determine public awareness and knowledge of prostate cancer, which has not been adequately studied in Japan.

METHODS

Assessment was made of public awareness and perception of prostate cancer in Japan, based on health examination data for participants in a short-stay physical examination program ("human dry dock"). A multiple-choice, thirty-point questionnaire survey was conducted at 3 "human dry dock" medical facilities situated in urban areas.

RESULTS

Many Japanese adults appeared to be inadequately aware of prostate cancer and of the means available for its early detection. One third of the participants were unfamiliar with this malignancy. Logistic regression analysis indicated smoking to be the only covariate associated with lack of knowledge of prostate cancer (P< 0.05). Seventy-one percent of the subjects had heard of digital rectal examination, but only 16% and 8%, respectively, were familiar with the terms transrectal ultrasonography and PSA testing. Japanese people may possibly be less informed about prostate cancer than African-American males. Both "human dry dock" facilities and subject gender were significantly associated with knowledge of digital rectal examination (P< 0.05). Knowledge of transrectal ultrasonography was found to depend on participation in "human dry dock" programs and level of education (P< 0.05). Smoking, participation in "human dry dock" programs under employer direction, and health status were all identified as determinants for knowledge of PSA testing (P< 0.05).

CONCLUSION

Educational programs should be established and put into effect to instill adequate awareness of prostate cancer in Japan. In a better-informed society, more effort would be directed toward prevention and thus early stage prostate cancer would be detected more often.

Significance of measurement of prostate specific antigen (PSA) in familial prostate cancer lines

The concentration of prostate specific antigen (PSA) in serum was measured in 20 brothers or sons in 10 families in which the father and son or brothers had prostate cancer using the E test TOSOH IIPA. The patients were between 32 and 70 years old with a mean age of 48.2 years. The PSA value was between 0.4 and 19.5 ng/ml with a mean value of 3.4 ng/ml. Five patients (25%) had PSA values exceeding the cut-off value of 4.0 ng/ml. After obtaining their consent, systematic prostate needle biopsy by transrectal ultrasonography was performed on 3 patients (15%). Prostate cancer was detected in all of them. Among them 2 patients were brothers, and since the other two brothers already had prostate cancer, all four brothers were confirmed to have prostate cancer. This is the first report of a familial prostate cancer in four brothers in Japan. In the western countries where the incidence of prostate cancer is higher than that in Japan, studies have been performed on the risk factors. Family history is one of the most important risk factors. In Japan, the incidence of prostate cancer is increasing rapidly. Moreover, patients with a prostate cancer family history are expected to increase. In such cases, prostate cancer screening should be performed aggressively from a young age.