Undetected carcinoma of the prostate at Kenyatta National Hospital

Abstract

Background: The incidence of undetected carcinoma of the prostate has been decreasing in Western Europe after the introduction of PSA and ultrasonography testing for patients with benign prostatic enlargement (BPE), who presents with bladder outlet obstruction. In an earlier retrospective study done in our set up in 1993 before extensive use of PSA and ultrasonography, the incidence of incidental carcinoma of the prostate was 13 %. Objective: The study was intended to determine the incidence of undetected carcinoma of the prostate at Kenyatta national hospital, in patients presenting with bladder outlet obstruction (BOO) thought to be BPE. Design: This was a descriptive prospective study, carried out between 15thAugust 2005 and so" April 2.006. Setting: The study was carried dut at Kenyatta National Hospital, which is a teaching and referral hospital. Subjects: One hundred and six patients were recruited into the study. Results: The patients' age range was between 60 and 100 years with a mean of75 years. Seven patients were found to have undetected carcinoma of the prostate, in patients presenting with BOO due to BPE. The incidence was 6.6%. Of the undetected carcinoma 42% of the patients had adenocarcinoma, 29% had prostate intraepithelial neoplasm (PIN) and 29% had anaplastic carcinoma. PSA levels were between zero to 4ng/ml and majority of the patients (72%) had PSA between three and 4ng/ml Majority of patients, with carcinoma were from Central province, 57% followed by 29% from Nyanza and 14% from eastern province. Conclusion: Incidence of undetected carcinoma of the prostate in patients presenting with BOO at KNH was 6.6% with 50% reduction from previous 13% in our local set up. Study by Reeves H.K. in 1993