Hypothetical Place of Transrectal Ultrasound in the Diagnosis of Prostatic Cancer at an Early Stage

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Abstract
In order to clarify the place of transrectal prostatic ultrasound examination (TRPS) in the diagnosis of prostatic cancer at early stage, 666 patients have been screened in 1 year. Of these, 602 had a normal, firm, or hyperplastic but nonnodular prostate (T0) by digital rectal examination (DRE); 41 had a T1-T2 prostate; and 23 had a T3-T4 prostate. Among those with T0 prostates, 162 had a hypoechoic peripheral area, which was biopsied: 11 lesions were infiltrating carcinomas. The ability to detect a T0 cancer with TRPS alone is assessed at 1.8% (11/602). The positive predictive value of a hypoechoic image of the prostate is assessed at 7% (11/162), which is much lower than the figures reported in the literature. TRPS can be considered an acceptable means of detecting T0 tumors of the prostate with a yield comparable to that of DRE in the T1-T4 tumors. The low performance (1.8%) of TRPS in detecting cancer at early stage rules out massive screening program of the male population over 50 years old. However, 45% of the localized tumors in this series were picked up by TRPS alone.
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