Date of Award
2020
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Dr. Alli Akber Zehri
Second Supervisor/Advisor
Dr. Philip Adebayo
Third Supervisor/Advisor
Dr Ali Athar
Department
General Surgery (East Africa)
Abstract
Background: Prostate carcinoma carries higher morbidity and mortality when diagnosed late. Prostate cancer screening is paramount, however, there are no specific clinical signs for early-stage prostate cancer. As an independent variable, prostate-specific antigen is an established predictor of cancer. Incidental prostate cancer is detected by histological examination of resected biopsy tissue that had been previously diagnosed as benign. In the current PSA-use era the prevalence of incidental prostate cancer ranges from 1.4 to 13%. The prevalence in Tanzania as published by Gunda et al was 21.71%. This is alarmingly high. However, in his study, patients with high prostate-specific antigens were included. Objective: To determine the prevalence of incidental prostate carcinoma among patients undergoing transurethral resection of the prostate for benign prostate enlargement with prostate-specific antigen less than 5.5 ng/ml.
Methods: A retrospective hospital-based cross-sectional study was conducted to establish the prevalence of incidental prostate cancer among men who underwent transurethral resection of the prostate with a considered normal range of prostate-specific antigen from 2010 to 2019 in Dar es Salaam, Tanzania. A minimum of 195 participants were reviewed, and factors associated with incidental prostate carcinoma were evaluated by binary regression analysis.
Results: A total of 195 men were included in the study. The prevalence of incidental prostate cancer among men with prostate-specific antigen levels of less than 5.5ng/mL was 7.2%. More than half of the patients had high-grade cancer, and three quarters had T1b histological subtype making up the clinically significant category. For every one year increase in age from 76 years, v the risk of incidental prostate cancer increased by 1.6, and for every unit increase in prostate specific antigen, incidental prostate cancer increased by 2.2. Conclusion: The Incidental prostate cancer detection rate of 7.2% in our settings is within the Internationals range. Factors associated, were prostate-specific antigen levels and Age. 3.6% of all patient had high grade cancer with potential chance of progressing to an advance stage of prostate cancer
Recommended Citation
Mawalla, I. H. (2020). Prevalence and factors associated to incidental prostate carcinoma among patients undergoing turp for benign prostatic enlargement. (Unpublished master's dissertation). Aga Khan University, East Africa.