Prostate cancer in Jamaica: a 6-year review

It is generally believed that prostate cancer in Jamaica is of very high incidence, that it is often diagnosed when patients are older, and that patients tend to have high PSA levels at diagnosis, suggesting more advanced disease.

Coard and Skeete sought to document the clinicopathological characteristics of prostate cancer in a public hospital-based population in Jamaica (the University Hospital of the West Indies) over a 6-year period, and to examine trends in these characteristics over time.

All patients diagnosed with prostate cancer by transrectal ultrasound-guided biopsy between January 2000 and  December 2005 were identified at time of diagnosis, and relevant clinical and pathological data were collected from the accompanying histopathology request forms.

The study has now reported the following results:

  • There were 529 cases of prostate cancer diagnosed over the 6-year period.
  • The mean age of newly diagnosed patients was 70.66 ± 8.74 years, with 137 patients (25.9 percent aged between 70 and 74 years at time of diagnosis.
  • Serum PSA levels were obtained for 490/529 patients (92.6 percent).
    • An accurate PSA value was available for 456 patients (86.2 percent)
    • A “minimum” PSA level was recorded for 34 patients (6.4 percent), all of whom had a PSA level of >100 ng/ml.
  • Of the patients with available PSA information
    • 91 (18.5 percent) had a PSA level of ≤ 10.0 ng/ml
    • 155 (31.6 percent) patients had levels of >100 ng/ml
  • The median PSA level for patients with accurate values was 30.7 ng/ml (with a PSA range from 1 to 14,260 ng/ml).
  • Moderately differentiated cancers accounted for 198 cases (37.5 percent).
  • Poorly differentiated cancers accounted for 160 cases (30.2 percent).
  • There was a statistically significant correlation between serum PSA level and Gleason score.
  • Statistical analysis of all other variables, including the number of cases of prostate cancer diagnosed annually, showed no significant differences.

The authors conclude that, despite increasing public awareness of prostate cancer, there was no significant change in the profile of Jamaican patients with prostate cancer at the time of diagnosis over the 6 years from 2000 to 2005. They further state that these findings are consistent with the lack of any organized, national screening initiative for prostate cancer in Jamaica.

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