Frequency of Unnecessarily Biopsies among Patients with Suspicion of Prostate Cancer in Syrian Men

Background: The prevalence of prostate cancer is considered high in many countries, and screening tests arevery important in order to detect prostate cancer in its early stages; however false positivity with these screeningtests means that a lot of patients undergo unnecessary biopsy, which is an invasive procedure, for the confirmatorytest. The purpose of this study was to estimate the frequency of unnecessary biopsy cases in patients referredfor prostate biopsy in one of the most important and overload cancer centers in Syria. Materials and
Methods:Retrospective data for a period of four years between January 2009 and December 2012 were collected in Al-Bayrouni University Medical hospital in Damascus, Syria. The patients from whom data were collected werereferred to our histopathological department because of elevated prostate specific antigen (PSA) serum or anabnormal digital rectal examination (DRE). All patients underwent prostatic TRUS-guided biopsies. Diagnosisof prostate cancer (PCa) or benign prostatic hyperplasia (BPH) was based on histopathological examinationand prostate cancers cases were graded and scored according to the Gleason score system.
Results: For the 406patients referred to biopsy, the mean±SD age was 58.4 ±23.3 years. The mean ± SD PSA level was 49.2±21.5 ng/ml. Of the total we found 237 patients diagnosed with PCa (58. 4%), 166 patients with BPH (40.9%) and 3 caseswere unable to be diagnosed (0.7%) because of biopsy collection errors.
Conclusions: Our study shows that ahigh percentage of patients are undergoing unnecessary biopsy, which suggests that the performed screeningtests had a high level of false positive and may need re-evaluation.