Introduction and aims: Prostate cancer is the most common malignant tumor in male; its diagnostic algorithm and therapy were investigated. The goal of the study was to compare the data from the first year of clinical use of prostate specific antigen (1994) and the data of 2004.
Results: During the first decade, the number of prostate biopsies has increased 4.5-fold times. In 1994, 36.2%, while in 2004, 47.5% of the biopsies demonstrated cancer. The average age of the patients, who underwent biopsy, decreased from 69.7 to 62.3 years; however, the average age of patients who suffered from prostate cancer remained constant (70.8 vs. 71.3 years old).
Conclusion: In 2004, along with the earlier used PSA level, the free-PSA and PSA-density was also involved in the diagnostic algorithm. The prostate biopsy is guided by a transrectal US, in contrast to the earlier used blind or transperineal method. Consequently, the effectiveness of the prostate biopsy has improved, but the earlier diagnosis and identification are not assured. The Gleason score of the diagnosed prostate cancer was lower; therefore, more patients were selected for curative surgery. The increased average PSA level reflected a higher number of patients at an advanced stage, which could only be treated palliatively.