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Mailankody S, Godkhindi VM, Udupa K, Pai A, Budukh A, Noronha V, Prabhash K, Rajaraman S. A Glimpse into the Epidemiology of Geriatric Cancers in India: Report from the Indian Population Based Cancer Registries. Asian Pac J Cancer Prev 2024; 25:2011-2022. [PMID: 38918663 PMCID: PMC11382867 DOI: 10.31557/apjcp.2024.25.6.2011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Indexed: 06/27/2024] Open
Abstract
INTRODUCTION Indian population is aging and the cancer rates are rising. Older adults (OAs)(≥60 years) with cancer require specialized care. However, data on geriatric cancer epidemiology is scarce. METHODS The study compiled the geriatric cancer data from the published reports(2012-2014) of Indian population-based cancer registries(PBCRs). RESULTS Of the 1,61,363 cancers registered in the Indian PBCRs, 72,446(44.9%) occur in OAs, with 21,805(30.1%), 18,349(25.3%), 14,645(20.2%), and 17,647(24.4%) occurring in 60-64, 65-69, 70-74, and ≥75year age groups. The truncated incidence rates for OAs are 555.9,404.5, and 481.9 for males, females, and OA populations respectively. The common cancers are lung, prostate, and esophagus cancers in males, breast, cervix, and lung in females. The overall common cancers are lung, prostate, and breast. While >50% of the incident cases of prostate, and bladder cancers occurred in OAs, <20% of Hodgkin lymphoma and thyroid cancers occurred in OAs. OA cancer epidemiology has a regional variation, highest in South India and lowest in Western India. CONCLUSION The current study quantifies the cancer burden in the Indian geriatric population. Understanding the epidemiology of geriatric cancers is vital to health program planning and implementation. Increased awareness, focused resource allocation, research, and national policies for streamlining care will all help to improve geriatric cancer outcomes.
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Affiliation(s)
- Sharada Mailankody
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | | | - Karthik Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ananth Pai
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India
| | - Swaminathan Rajaraman
- Department of Epidemiology, Biostatistics and Cancer Registry, Cancer Institute (WIA), Chennai, India
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Sharma M, Nerli RB, Nutalapati SH, Ghagane SC. Hypoehoic lesions on Transrectal Ultrasound and its correlation to Gleason grade in the diagnosis of Clinically Significant Prostate Cancer: A Prospective Study. South Asian J Cancer 2021; 10:155-160. [PMID: 34938677 PMCID: PMC8687870 DOI: 10.1055/s-0041-1731906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context
The importance of hypoechoic lesions on transrectal ultrasound (TRUS) merits re-assessment in the present era of widespread prostate-specific antigen (PSA) testing.
Aims
We aimed to investigate the predictive accuracy of hypoechoic lesions on TRUS of prostate in the diagnosis of prostate cancer and to examine the association of hypoechoic lesions with the aggressiveness of prostate cancer.
Settings and Design
This prospective study was conducted in a tertiary care center in South India from November 2017 to December 2019.
Methods and Material
We included 151 patients undergoing TRUS-guided 12-core prostate biopsy in view of raised serum PSA with or without suspicious digital rectal examination (DRE) findings in the study. Age, DRE findings, serum PSA level, TRUS findings, and histopathology reports were documented. These were compared between patients with and without hypoechoic lesions on TRUS.
Statistical Analysis Used
The statistical analysis for this study was performed using SPSS v20.0 software.
Results
Among 151 men, prostate cancer was diagnosed in 68 (45.03%) with mean age at presentation 69.81 ± 6.49 years. Fifty-eight cases (38.41%) had hypoechoic lesion on TRUS and the cancer detection rate (68.96%) amongst this group was significantly higher than in those without hypoechoic lesion (
p
<0.0001). Patients with hypoechoic lesion were more likely to have higher grade cancer. Abnormal DRE findings and hypoechoic lesion on TRUS were independent predictors of a clinically significant cancer (
p
<0.05).
Conclusion
Hypoechoic lesion on TRUS can be considered as an indicator of clinically significant prostate cancer.
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Affiliation(s)
- Manas Sharma
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Rajendra B Nerli
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Sree Harsha Nutalapati
- Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Shridhar C Ghagane
- Department of Urology, KLES Kidney Foundation, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India
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Mandhani A, Mittal V, Bhaskar V, Srivastava A. Prostate-specific antigen screening of men with lower urinary tract symptoms (opportunistic screening) and of asymptomatic men undergoing executive health check: an audit from two institutions. Indian J Urol 2021; 37:159-162. [PMID: 34103799 PMCID: PMC8173934 DOI: 10.4103/iju.iju_478_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/06/2020] [Accepted: 03/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: We evaluated incidence ofprostate-specific antigen (PSA) positivity (>4ng/mL) and cancer detection rate on prostate biopsy in two populations of men, one undergoing opportunistic testing for lower urinary tract symptoms and another during routine health checks. Methods: Data regarding PSA screening, rectal examination (RE), transrectal ultrasound-guided biopsy, clinical stage, and risk assessment grouping according to NCCN guidelines were studied. Group A included patients with lower urinary tract symptoms (LUTS) (opportunistic screening) at SGPGIMS, Lucknow and Group B included healthy men who had executive health check-up with PSA testing at Medanta the Medicity, Gurugram. Results: PSA positivity rate in 9906 symptomatic men for LUTS (Group A) and 24919 healthy men (Group B) was 28.4% and 3% respectively. In group A, PSA positivity rate was 28.4% but only around half of all men with an indication underwent a biopsy. Among men with PSA of 4–10 ng/mL, cancer was detected in 93 of 241 who underwent a biopsy (38.5%). In Group B, only 69 men (9.3% of those with an elevated PSA) underwent a prostate biopsy, of which 38/57 (with PSA of 4–10 had cancer. In Group A, the cancers was metastatic in 61.5% men, while none in-Group B had metastatic disease. Conclusion: Opportunistic screening and executive health check with PSA identifies a significant number of men with PSA positivity and may help decrease the proportion of men diagnosed in metastatic prostate cancer.
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Affiliation(s)
- Anil Mandhani
- Department of Urology and Renal Transplant, Medanta The Medicity, Gurgaon, Haryana, India
| | - Varun Mittal
- Department of Urology and Renal Transplant, Medanta The Medicity, Gurgaon, Haryana, India
| | - Ved Bhaskar
- Department of Urology and Renal Transplant, Medanta The Medicity, Gurgaon, Haryana, India
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Patil SR, Pawar PW, Sawant AS, Patil AV, Narwade SS, Mundhe ST, Savalia AJ, Tamhankar AS. TRUS Biopsy Yield in Indian Population: A Retrospective Analysis. J Clin Diagn Res 2017; 11:PC01-PC05. [PMID: 28384926 DOI: 10.7860/jcdr/2017/25473.9251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The reported cancer detection rate of Trans-Rectal Ultrasonography (TRUS) biopsies (TRUS biopsy yield) has been around 30 percent in western countries. However it is much lower in Asian countries, including India. Hence a larger proportion of patients in India undergo unnecessary biopsies. AIMS To find out the cancer detection rate of TRUS biopsy (TRUS biopsy yield) in contemporary Indian population. Also, to study the positive predictive values at different serum Prostate-Specific Antigen (PSA)/PSA Density (PSAD) cut off levels and suspicious Digital Rectal Examination (DRE) findings. MATERIALS AND METHODS This retrospective study was carried out in a tertiary care institute. All symptomatic patients who underwent TRUS guided biopsy for indication of raised serum PSA level (>4 ng/ml) or suspicious DRE findings (nodule, irregularity, hard consistency, immobile rectal mucosa) from January 2012 to December 2014 were included. For serum PSA range (4-10) ng/ml, TRUS guided biopsy was done in patients with percent free/total PSA < 25. Statistical analysis used were Chi-square test, Mann-Whitney U-test, Spearman's rank correlation analysis and Receiver-Operating Characteristic (ROC) curve. RESULTS Out of the 235 patients included, 60 patients had malignancy (overall cancer detection rate= 25.53%). The cancer detection rate for PSA ranges of (4-10) and (10-20) ng/ml was as low as 5.95% and 13.16% respectively. Patients with malignant disease had significantly smaller prostate gland size than patients with benign disease (53.89 vs 63.06; p-value <0.05). On the other hand, cancer detection rate was 100% for PSA greater than 50ng/ml. The cancer detection rates were only upto 10% for PSA density ranges upto 0.25 ng/ml/cm3. The Area Under the Curve (AUC) for PSA and PSAD was 0.876 and 0.884 respectively. Only one patient (0.43%) had post-biopsy complication (acute bacterial prostatitis) requiring hospital admission. CONCLUSION The current serum PSA and PSAD cut offs of 4 ng/ml and 0.15 ng/ml/cm3 need to be raised for Indian population to increase its positive predictive value. Prospective study validation of this finding is lacking.
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Affiliation(s)
- Sunil Raghunath Patil
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Prakash Wamanrao Pawar
- Assistant Professor, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Ajit Somaji Sawant
- Professor and Head of Department, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Akshay Vijay Patil
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Sayalee Suryabhan Narwade
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Shankar Tanaji Mundhe
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Abhishek Jaysukhbhai Savalia
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
| | - Ashwin Sunil Tamhankar
- Senior Registrar, Department of Urology, Lokmanya Tilak Municipal Medical College and General Hospital , Mumbai, Maharashtra, India
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Abstract
Introduction: The incidence of prostate cancer has shown significant variation across the globe. Though the prevalence and characteristics of this disease have been extensively studied in many countries, data regarding the true incidence of prostate cancer in India is limited. Materials and Methods: MEDLINE publications from 1990 to 2014 were searched and reviewed and compiled to assess the demographic profile of prostate cancer in India and characteristics unique to this disease in India. Results: The limited data available on prostate cancer showed significant differences in incidence, precipitating factors, and disease characteristics of prostate cancer in India. Conclusions: Since India would be having more number of cases of prostate cancer than most others in the years to come, adequate population-based data regarding the demography and disease characteristics of this disease are of paramount importance in this country.
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Abstract
One of the most important diagnostic tools used to detect prostate cancer is prostate-specific antigen (PSA), yet increased PSA alone does not reflect the presence of prostate cancer. Other pathological prostatic conditions such as prostatitis and benign prostatic hyperplasia (BPH) may also increase the level of PSA. However, unlike in other prostate diseases, PSA has a key role in the diagnosis and management of prostate cancer. The incidence of prostate cancer varies from country to country, with the highest incidence being found in the Western world and the lowest in Asian countries. Owing to the low incidence of prostate cancer, there could be different views regarding the use of PSA in Asian countries, especially for the early detection/screening of prostate cancer. The purpose of this article is to review the use and value of PSA in the diagnosis of prostate diseases (especially prostate cancer) in Asian countries/populations. A literature search was performed in 'MEDLINE' (PubMed) and Google Scholar using main keywords such as 'PSA', 'PSA usage', 'PSA sensitivity and specificity', 'Asia', and various countries in Asia. Articles that provide population/community-based PSA data, together with the characteristics, distribution, and indications for PSA testing in the respective countries, were selected. Eleven papers were finally selected for inclusion in this review. Five studies found that PSA, by its 95th percentile value, have an age-referenced tendency in Asian males, similarly to the West. The predictive values of PSA in detecting prostate cancer are also quite similar to those in Western countries. With the exponential growth of the aging population in the world, especially in Asia, the incidence of prostate cancer will follow this upward trend. Therefore, PSA testing for screening or diagnostic purposes would increase with time in Asia.
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Affiliation(s)
- Chaidir Arif Mochtar
- Department of Urology, Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jalan Diponegoro 71, Jakarta 10430, Indonesia
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Kuasne H, Rodrigues IS, Fuganti PE, Losi-Guembarovski R, Ito K, Kishima MO, Rodrigues MADF, Rogatto SR, Santos RMD, Cólus IMDS. Polymorphisms in the AR and PSA genes as markers of susceptibility and aggressiveness in prostate cancer. Cancer Invest 2010; 28:917-24. [PMID: 20632874 DOI: 10.3109/07357907.2010.483509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study of genes involved in androgen pathway can contribute to a better knowledge of prostate cancer. Our aim was to examine if polymorphisms in prostate-specific antigen (PSA) and androgen receptor (AR) genes were involved in prostate cancer risk and aggressiveness. Genotypes were determined by PCR-RFLP (PSA) or using a 377 ABI DNA Sequencer (AR). PSA(G/G) genotype (OR = 1.78, 95% CI = 1.06–2.99) and AR short CAG repeats (OR = 1.89, 95% CI = 1.21–2.96) increased risk for prostate cancer and were related with tumor aggressiveness. About 38.3% of tumors showed microsatellite instability. In conclusion, polymorphisms in these genes may be indicated as potential biomarkers for prostate cancer.
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Affiliation(s)
- Hellen Kuasne
- Department of General Biology, Biological Science Center, Londrina State University, Paraná, Brazil
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