The Impact of Prostate Specific Antigen Testing on Incidence of Prostate Cancer cases in Zimbabwe
Abstract:
Prostate
cancer is the leading cancer causing death in Zimbabwean men according to the
Zimbabwe National Cancer Registry. By 2004 prostate cancer had become the most
common cancer in Zimbabwean men. The incidence of prostate cancer shows strong
age, race and geographical dependence. The prostate specific antigen (PSA) is a
serine protease produced by cells of the prostate gland. The PSA blood test
measures the level of PSA in man’s blood and is used as a biomarker for
prostate cancer (PCa). Unfortunately the PSA is prostate specific but not PCa
specific. PSA testing started in Zimbabwe in 1995. The specific objectives of
the study were: (i) to determine the age range most affected by PCa, (ii) to
evaluate the impact of PSA testing on PCa cases in Zimbabwe. The study was a
retrospective cross sectional study. Secondary data of all histology confirmed
cases of PCa were obtained from the Zimbabwe National Cancer Registry (ZNCR)
and analysed. Graph Pad Prism 7.03 was used to statistically analyse the data.
The two-tailed T-test was employed to compare the number of pre-PSA cases
against the number of post PSA era cases. 5277 PCa cases covering a thirty year
period were retrieved. The first ten years (1986-1995) were the pre PSA era period
and the next twenty years (1996-2015) were the post PSA era. The median age was
71 (IQR 64-78) years. There was a significant difference between number of PCa
cases of the pre-PSA era (1986-1995) and the first post PSA era 1996-2005, and
the second PSA era (2006-2015) (p =0.0042 and p=0.0028 respectively. This showed
the impact that PSA testing had on PCa in Zimbabwe (2006- 2015). The study
showed that the age group most affected by PCa was the 64-78 years. .
Keywords: Prostate cancer, Cross
Sectional Study, Prostate Specific Antigen, PSA impact, age group, Zimbabwe.
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