• 보건교육건강증진학회지
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• 제30권4호
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• pp.99-110
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• 2013

Objectives: This study aimed to investigate factors related to prostate disease and follow-up procedure on health examination program in Gangwon-do. Methods: The studied population was 16,501 male aged 40 or more, who underwent screening tests for prostatic disease in 2011 health examination program designed for the low income residents in Gangwon-do. The screening tests included prostate specific antigen (PSA), international symptom score (IPSS), and maximal flow rate (Qmax). We conducted chi-square test for trend, two independent samples t-test, and binary logistic regression to find out the relationship between prostate cancer or benign prostatic hyperplasia and risk factors such as age, PSA level, and IPSS. Results: The number of subjects who turned out positive for PSA level (> 3.8ng/ml) was 971 men accounting for 5.9%. The result of post survey on them showed that 511 subjects (52.6%) got the urology check-up: 156 (30.5%) were diagnosed as normal, 286 (56.0%) as benign prostatic hyperplasia, and 69 (13.5%) as prostate cancer. The detection rate for prostate cancer was 8.8% when PSA level was between 3.81 and 9.99g/ml, and was 30.6% when PSA level was more than 10.00ng/ml. The rates of further testing varied depending on the communities from 26.7% to 68.2%, which was mainly affected by the role of local health center. Conclusions: Our findings indicate that enhanced quality control of local health center and empowerment of screening agency would increase the effort of coupled institutions between public and private sectors.

• 보건교육건강증진학회지
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• 제19권3호
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• pp.135-152
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• 2002

Objectives: Cancer is the most frequent cause of death in Korea. Cancer screenings can save lives through early detection and their effect can be enhanced by regular repeat adherence rather than one-time screening. The aim of this study was to investigate major cancer screening rates and the reasons for not having screening for providing the basic data required. Materials and Methods: The study sample were recruited from the parents of students in 3 different middle and high schools in Pusan. 428 participants(l93 of males, 214 of females) completed a structured self-administered questionnaire from Dec. 21 to 31, 2001 and the response rate was 73.8%. Data were analyzed using descriptive statistics with SPSS Win 10.0. Results: The cancer screening rates of the subjects(male and female respectively) who have had one or more in their life-time were about 36.3% and 34.6% in gastroendoscopy for stomach cancer, about 11.1 % and 8.5% in stool hemocult test and colonoscopy for colon cancer, 13.5% and 9.3% in prostate-antigen test and rectal digit exam for prostate cancer, 36.4% in mammograpy for breast cancer, and 59.3% in Pap smear test for cervical cancer. And the higher proportions of having regular screening were 36.0% in Pap smear test for cervical cancer and 11.7% in mammograpy for breast cancer. The reasons related to not having screening tests were found that ‘seem to be healthy’ was 44.8%∼58.9% and the most common reason and the following was ‘not having opportunity for check-up’. The most common reason related to not having regular screening tests were ‘for the finding of previous check-up was normal’.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5281-5286
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• 2013

Purpose: Prostate cancer caused by the abnormal disorderly growth of prostatic acinar cells is the most prevalent cancer of men in western countries. We aimed to screen out differentially expressed genes (DEGs) and explore small molecule drugs for prostate cancer. Materials and Methods: The GSE3824 gene expression profile of prostate cancer was downloaded from Gene Expression Omnibus database which including 21 normal samples and 18 prostate cancer cells. The DEGs were identified by Limma package in R language and gene ontology and pathway enrichment analyses were performed. In addition, potential regulatory microRNAs and the target sites of the transcription factors were screened out based on the molecular signature database. In addition, the DEGs were mapped to the connectivity map database to identify potential small molecule drugs. Results: A total of 6,588 genes were filtered as DEGs between normal and prostate cancer samples. Examples such as ITGB6, ITGB3, ITGAV and ITGA2 may induce prostate cancer through actions on the focal adhesion pathway. Furthermore, the transcription factor, SP1, and its target genes ARHGAP26 and USF1 were identified. The most significant microRNA, MIR-506, was screened and found to regulate genes including ITGB1 and ITGB3. Additionally, small molecules MS-275, 8-azaguanine and pyrvinium were discovered to have the potential to repair the disordered metabolic pathways, abd furthermore to remedy prostate cancer. Conclusions: The results of our analysis bear on the mechanism of prostate cancer and allow screening for small molecular drugs for this cancer. The findings have the potential for future use in the clinic for treatment of prostate cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7085-7088
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• 2015

Background: The high incidence of prostate cancer as the most common malignancy in males in many countries raises the question of developing reliable detection tests. The prostate specific antigen (PSA) test is the most widely used for screening for prostate cancer; however, its low specificity elevates the number of unnecessarily biopsies. Serum human kallikrein-2 (hK2) is considered as a promising marker, and especially its ratio to fPSA, for predicting the presence of malignancy to select the best choice referring to biopsy or surveillance. In this study, we investigated the role of hK2 and its combinations with other markers to discriminate prostate cancer from benign diseases in Syrian patients. Materials and Methods: In this prospective oriented cross-sectional cohort study, serum samples were collected from patients referred to many Hospitals in Damascus, Syria, between May 2011 and March 2012, and diagnosed with biopsy proven benign prostate hyperplasia (BPH) or prostate cancer (PCa). Serum was analyzed for hK2, PSA and fPSA, and the ratios of fPSA/PSA and hK2/fPSA were calculated. Results: We found that mean hK2/fPSA ratios were significantly higher (P=0.01) in prostate cancer patients than in the BPH or control groups. Also the ratio hk2/fPSA gave the largest area under the curve (AUC:0.96) which was significantly larger than for fPSA/PSA (AUC:0.41) indicative of higher specificity. Conclusions: Our results demonstrate that the ratio of hK2/fPSA might be superior to the use of fPSA/PSA alone. The hK2 could be shown to enhance the early detection of prostate cancer; especially the ratio hK2/fPSA improves specificity and hence may reduce the number of negative biopsies.

• Journal of Preventive Medicine and Public Health
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• 제55권3호
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• pp.243-252
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• 2022

Objectives: Very limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method. Methods: Seven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state. Results: The mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis. Conclusions: Our findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6245-6250
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• 2012

Background: With increase in life expectancy, adoption of newer lifestyles and screening using prostate specific antigen (PSA), the incidence of prostate cancer is on rise. Globally prostate cancer is the second most frequently diagnosed cancer and sixth leading cause of cancer death in men. The present communication makes an attempt to analyze the time trends in incidence for different age groups of the Indian population reported in different Indian registries using relative difference and regression approaches. Materials and Methods: The data published in Cancer Incidence in Five Continents for various Indian registries for different periods and/or publications by the individual registries served as the source materials. Trends were estimated by computing the mean annual percentage change (MAPC) in the incidence rates using the relative difference between two time periods (latest and oldest) and also by estimation of annual percentage change (EAPC) by the Poisson regression model. Results: Age adjusted incidence rates (AAR) of prostate cancer for the period 2005-2008 ranged from 0.8 (Manipur state excluding Imphal west) to 10.9 (Delhi) per $10^5$ person-years. Age specific incidence rates (ASIR) increased in all PBCRs especially after 55 years showing a peak incidence at +65 years clearly indicating that prostate cancer is a cancer of the elderly. MAPC in crude incidence rate(CR) ranged from 0.14 (Ahmedabad) to 8.6 (Chennai). Chennai also recorded the highest MAPC of 5.66 in ASIR in the age group of 65+. Estimated annual percentage change (EAPC) in the AAR ranged from 0.8 to 5.8 among the three registries. Increase in trend was seen in the 55-64 year age group cohort in many registries and in the 35-44 age group in Metropolitan cities such as Delhi and Mumbai. Conclusions: Several Indian registries have revealed an increasing trend in the incidence of prostate cancer and the mean annual percentage change has ranged from 0.14-8.6.

• Molecules and Cells
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• 제38권2호
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• pp.171-179
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• 2015

Prostatic acid phosphatase (PAP) expression increases proportionally with prostate cancer progression, making it useful in prognosticating intermediate to high-risk prostate cancers. A novel ligand that can specifically bind to PAP would be very helpful for guiding prostate cancer therapy. RNA aptamers bind to target molecules with high specificity and have key advantages such as low immunogenicity and easy synthesis. Here, human PAP-specific aptamers were screened from a 2'-fluoropyrimidine (FY)-modified RNA library by SELEX. The candidate aptamer families were identified within six rounds followed by analysis of their sequences and PAP-specific binding. A gel shift assay was used to identify PAP binding aptamers and the 6N aptamer specifically bound to PAP with a Kd value of 118 nM. RT-PCR and fluorescence labeling analyses revealed that the 6N aptamer bound to PAP-positive mammalian cells, such as PC-3 and LNCaP. IMR-90 negative control cells did not bind the 6N aptamer. Systematic minimization analyses revealed that 50 nucleotide sequences and their two hairpin structures in the 6N 2'-FY RNA aptamer were equally important for PAP binding. Renewed interest in PAP combined with the versatility of RNA aptamers, including conjugation of anti-cancer drugs and nano-imaging probes, could open up a new route for early theragnosis of prostate cancer.

• 대한비뇨기종양학회지
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• 제16권3호
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• pp.103-109
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• 2018

Purpose: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. Materials and Methods: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. Results: The mean age was $52.0{\pm}4.7years$, and the mean PSA was $0.97{\pm}0.99ng/mL$. The PSA showed a significant positive correlation with the age (r=0.108, p<0.01), TPV (r=0.349, p<0.01), height (r=-0.052, p<0.05), weight (r=0.186, p<0.05), low-density lipoprotein cholesterol (r=0.056, p<0.05), and GFR (r=-0.096, p<0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=-0.013, p<0.001; beta=-0.039, p<0.001; and beta=-0.010, p=0.005; respectively) in age and TPV-adjusted model. Conclusions: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1259-1275
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• 2015

Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2835-2838
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• 2013

Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.