Prostate Cancer Diagnostic Methods in Korle Bu Teaching Hospital, Accra, Ghana

Objective: The diagnosis of prostate cancer is based on a combination of digital rectal examination (DRE), serum prostate specific antigen (SePSA) estimation and trans-rectal ultrasound guided biopsy (TRUS-B) of the prostate, the latter being the gold standard for prostate cancer diagnosis. This study compared the diagnostic rate of prostate cancer in patients attending the urology clinic at Korle-bu Teaching Hospital, Accra, Ghana, using these methods.Patients and Methods: One hundred and fifty male patients 45 years and older with abnormal DRE and raised or rising SePSA had TRUS biopsy done. The biopsies were processed routinely and all cancer positive slides were graded using the Gleason scoringsystem. DRE findings were comparatively analysed statistically against SePSA and histological findings.Results: Of the 150 subjects, 71(47.3%) were diagnosed as benign and 79(52.7%) had cancer on TRUS-B. Cancer diagnosis rate using a combination of DRE and SePSA was slightly higher (66.4%) than using DRE (64.5%) or SePSA (53.7%) in isolation.Conclusion: DRE was found to have a high positive predictive value, probably due to the late presentation of majority of the patients in this study. SePSA alone is not very reliable, and results must be interpreted with caution due to significant false positive rates. Combining DRE and SePSA improves cancer diagnosis rates.