Detection rate of prostate cancer on biopsy according to serum prostate-specific antigen in Korean men: A multicenter study

OBJECTIVES: To evaluate the detection rate of prostate cancer on biopsy according to the serum prostate-specific antigen (PSA) level in Korean men and compare the detection rate with those of Japanese and American men in other studies. METHODS: We retrospectively analyzed 2422 Korean men who had undergone prostate biopsy at 12 medical centers from 1993 to 2002. In the case of a PSA level greater than 4.0 ng/mL or abnormal digital rectal examination findings, prostate biopsy was performed. RESULTS: Of the 2422 men, 962 (39.7%) were diagnosed with prostate cancer. With PSA levels between 4.0 and 10.0 ng/mL, the detection rate of prostate cancer was 15.9%. This rate was similar to that of Japanese men (15.8%), but lower than that of American men (25%). In the cases with a PSA level greater than 10.0 ng/mL, the detection rate for Korean and Japanese men was 59.5%, and was also lower than the 67% rate for American men. When serum PSA levels were divided into five subgroups (less than 4.0, 4.0 to 10.0, 10.0 to 20.0, 20.0 to 100.0, and greater than 100.0 ng/mL), the detection rate of prostate cancer was 12.4%, 15.9%, 34.1%, 66.2%, and 93.8%, respectively. CONCLUSIONS: In Korean men, the detection rate of prostate cancer on biopsy according to serum PSA level appears to be comparable to that for Japanese men and lower than that for American men.ope