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Factors affecting the diagnosis of prostate cancer through 12 quadrant guided prostate biopsy

Abstract Purpose Investigate the factors affecting the efficacy of the widely used 12-quadrant prostate biopsy for the diagnosis of prostate cancer. Methods The data of 1846 male patients between 45 and 75 years of age was evaluated. The patients were subdivided into groups according to age, blood prostate-specific antigen (PSA) levels prostate volume (PV), digital rectal examination (DRE) findings, and pathology results. The tumour detection rates in the 12-quadrant biopsies were compared with PV, PSA levels, and DRE results of the grouped patients. Results The tumour detection rate decreased with increasing PV in patients 45–75 years of age and with a PSA level ≤ 14.5. No decrease was detected in patients 45–60 years of age or those aged 61–75 years with a PSA ≤ 6.99 and suspicious DRE findings. A decrease in the tumour detection rate with increasing PV was observed in the other three subgroups of patients in this age group, who had a PSA ≤ 6.99, and normal DRE findings but a PV ≤ 40, PV 41–80, or PV ≥ 81. Conclusions Even though there is no statistically significant relationship between PV and the prostate cancer detection rate in patients 45–60 years of age, the cancer detection rate decreased with increasing PV in three of the four subgroups of patients between the ages of 61 and 75 years. Our study results have demonstrated that an individualised approach can play an important role in the diagnosis and treatment of prostate cancer.