NEW YORK (Reuters Health) Jun 19 - Almost half of men whose extended core needle prostatic biopsies reveal isolated high-grade prostatic intraepithelial neoplasia (HGPIN) subsequently develop prostate cancer, according to a study by UK researchers.
"There have been limited studies on HGPIN and risk of subsequent diagnosis of prostate cancer in the UK population," lead investigator Dr. Paras B. Singh told Reuters Health. "Our study shows that it carries a significant risk that warrants careful prostate specific antigen -- PSA -- follow-up and possible repeat prostate biopsies."
In a May 27th paper in BMC Urology, Dr. Singh of Lancaster University, Bailrigg, and colleagues report that they retrospectively studied data on 2,192 men who had undergone prostate biopsy.
The team found 88 cases of isolated HGPIN and 67 of these patients underwent 1 or more repeat biopsies. In the latter group, 28 patients (48%) were diagnosed with prostate cancer.
Neither the number of cores taken on the initial prostate biopsy nor the number of cores with HGPIN on the first biopsy was associated with subsequent prostate cancer detection. However, patients who subsequently had such a diagnosis were significantly older and had a higher mean PSA at the first set of prostate biopsies.
Based on these results, the researchers recommend delaying the first repeat biopsy in patients with PSA in the low range. Shorter intervals, they add, are appropriate for those with PSA values in the intermediate and higher ranges.
BMC Urology 2009;9.
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