PSA Pattern in Saudi Population KFSH&RC Jeddah

1. AnmarNassir, Assistant Prof, Um Al-QuraUniv Hasan Farsi, Prof, KAUH AmmarDehlawi, Teach assist Um Al-QuraUniv PSA Pattern in Saudi PopulationKFSH&RC Jeddah

2. Little is known about prostate cancer in Saudi Arabia. • National Cancer Registry data • GU Ca: 9.2% in KSA, vs 24.1% USA • Prostatic CA is X 50 lower than in USA • The most common GU CA in KSA is bladder, followed by the prostate, kidney, and testicular cancer. Introduction Abomelha , 2004

3. Our aim is : • to identify the pattern of PSA values in our population. • to identify the high risk patients: candidate for TRUS biopsy Aim

4. Between October 2002 and November 2007, all PSA values ordered at KFSH& RC in Jeddah were studied. • Data collected: • patient's age, • total PSA, • free to total ratio, • PSA velocity Material and method:

5. The overall average age • 63.8 (+/- 11.8 SD). • A total of 4210 specimen of PSA were analyzed for 2181 patients. Results:

6. PSA at initial presentation

7. Free to total PSA ratio for PSA of 4-10

8. For pts between 4-10 % according to cut points Free to total

9. PSA velocity was studied in 2803 PSA samples for 801 patients, • with an average of 3.5 samples for each patient. Results:

10. Results:

11. In the Eastern region of SA: • PSA screening of 1192 • 6.9 % indicated for TRUS Bx • Only 75 % agreed for Bx • CA in 14 only = 1.17% Discussion Baher et al 2005

12. In the western region: Out of 45 patients underwent TRUS guided biopsy; cancer of the prostate was detected in 13 (28.8%). Discussion Al- Tayib , 2003

13. 7.6%  in patients presented with abnormal DRE alone 15.3%  in the group with elevated PSA but normal DRE (stage T1c). cancer detection rate Al- Tayib , 2003

14. 21.4%  PSA was elevated to 4-10 ng/ml 40%  PSA to10-20 ng/ml 100%  PSA > 20 ng/ml cancer detection rate Al- Tayib , 2003

15. 21.4%  PSA was elevated to 4-10 ng/ml 40%  PSA to10-20 ng/ml 100%  PSA > 20 ng/ml cancer detection rate Al- Tayib , 2003

18. Sensitivity of CA detection: • PSA between 4-10 vs <4 ng/mL: • 79% for levels between 4 and 10 ng/mL. • 11% at levels below 4 ng/mL cancer detection rate

19. In a large prospective screening study • 47% among men with a PSA velocity > 0.75 ng/mL per year • 11% among men with a PSA velocity < 0.75 ng/mL per year cancer detection rate Smith and Catalona, 1994

20. At KFSH & RC Jd • 88 patients came back +ve for Prostate cancer. • 84/2181 = 4%

21. عن معاذ بن جبل ، أنهم خرجوا مع رسول الله صلى الله عليه وآله وسلم عام تبوك ... قال: "إنكم ستأتون غدا ، إن شاء الله عين تبوك ، وإنكم لن تأتوها حتى يضحى النهار ، فمن جاءها فلا يمس من مائها شيئا حتى آتي“ فجئناها ، وقد سبقنا إليها رجلان ، والعين تبض بشيء من ماء، فسألهما رسول الله:"هل مسستما من مائها شيئا؟ " فقالا : نعم . ...قال لهما ما شاء الله أن يقول . ثم غرفوا بأيديهم من العين ، قليلا قليلا . حتى اجتمع في شيء ، ثم غسل رسول الله صلى الله عليه وسلم ، فيه وجهه ويديه . ثم أعاده فيها ، فجرت العين بماء كثير . فاستقى الناس . ثم قال رسول الله صلى الله عليه وسلم : " يوشك يا معاذ إن طالت بك حياة، أن ترى ما هاهنا قد ملئ جنانا ” مالك في الموطأ 331 والإمام مسلم في صحيحه 4327