Prostate Specific Antigen Density Values Among Patients With Symptomatic Prostatic Enlargement In Nigeria

<strong>Background</strong> This study aims to estimate the prostate specific antigen density(PSAD) cut off level for detecting prostate cancer( CAP) in Nigerian men with “grey zone PSA’’(4-10ng/ml) and normal digital rectal examination findings . We addressed this research question: Is the international PSAD cut off of 0.15 ideal for detecting CAP in our symptomatic patients with “grey zone PSA’’? <strong> Methods</strong> Aim: To estimate the prostate specific antigen density(PSAD) cut off level for detecting prostate cancer( CAP) in Nigerian men with “grey zone PSA’’(4-10ng/ml) and normal digital rectal examination findings . Design: prospective Setting: A tertiary medical center in Enugu Nigeria Participants: Two hundred and fifty four men with either benign prostatic hyperplasia (BPH) or prostate cancer (CAP) were recruited. Intervention: Patients with PSA above 4ng/ml or abnormal digital rectal examination or hypoecoic lesion in the prostate were biopsied. Outcome measures: PSAD and histology report of BPH or CAP <strong>Results</strong> Ninety seven patients had cancer of the prostate (CAP) while 157 has benign prostatic hyperplasia (BPH). Seventy two patients had their serum PSA value within the range of 4.0 and 10ng/ml . PSAD cut off level to detect CAP was 0.04(sensitivity 95.88 %; specificity 28.7 %). <strong>CONCLUSION</strong> The PSAD cut off level generated for Nigerian men in this study is 0.04 which is relatively different from international consensus. This PSAD cut off level has a positive correlation with histology and could detect patients with CAP who have “grey zone PSA’’.