population-based prostate cancer screening in kazakhstan

Background: issues of mass screening for prostate cancer rather controversial since 2013 in 11 regions of kazakhstan introduced a population-based screening for prostate cancer, so we need to evaluate its results. methods: in different regions of kazakhstan during 2013-2015, a total of 321548 prostate-specific antigens (psa) were determined in men aged 50-66 yr, under the prostate health index (phi) and transrectal ultrasonography (trus) guided prostate biopsy with histological examination. results: psa level up to 4 ng/ml in 310870 (96.7%) men, psa level between 4 and 10 ng/ml in 8 624 (2.7%) men, psa level above 10 ng/ml in 2054 (0.6%) men. phi was identified in 5716 (1.8%) men, of which 2867 cases were with phi ≥ 25 (35.9%). totally, 3680 biopsies (1.1%) of the prostate were performed. as part of the screening, 2870 cases (0.88%) of benign prostatic hyperplasia and prostatic intraepithelial neoplasia were found. of 742 cases of prostate cancer (0.23%) were revealed. the stages of prostate cancer screening were as follows: stage i in 172 men (23.2%), stage ii in 444 men (59.8%), stage iii in 98 men (13.2%) and stage iv in 28 (3.8%) men. the indicators of prostate cancer early diagnosis in the i-ii stages were bigger in the “screening regions” than in the “traditional diagnostics” regions: rr 1.35 95% ci (1.24 – 1.46), or 1.84 95% ci (1.58–2.15). prostate cancer was detected at i-ii stages in the screening regions only by screening vs traditional diagnostics, with rr 1.64 95% ci (1.56 – 1.73), or 4.77 95% ci (3.87–5.87). conclusion: implementation of screening can improve the diagnosis of prostate cancer in the early stages.