1. Anmar Nassir, Assistant Prof, Um Al-Qura Univ Hasan Farsi, Prof, KAUH Ammar Dehlawi, Teach assist Um Al-Qura Univ

2.  Little is known about prostate cancer in Saudi Arabia.  National Cancer Registry data  GU Ca: 9.2% in KSA, vs 24.1% USA  Prostatic CA is X 50 lower than in USA  The most common GU CA in KSA is bladder, followed by the prostate, kidney, and testicular cancer.

3.  Our aim is :  to identify the pattern of PSA values in our population.  to identify the high risk patients: candidate for TRUS biopsy

4.  Between October 2002 and November 2007, all PSA values ordered at KFSH& RC in Jeddah were studied.  Data collected:  patient's age,  total PSA,  free to total ratio,  PSA velocity

5.  The overall average age  63.8 (+/- 11.8 SD).  A total of 4210 specimen of PSA were analyzed for 2181 patients.

6. PSA ng/ml < 2.5 < 4 4-10 >10 % of pt

7.  Free to total PSA ratio for PSA of 4-10

8. < 11< 18< 22< 25 no. %  For pts between 4-10  % according to cut points

9.  PSA velocity was studied in 2803 PSA samples for 801 patients,  with an average of 3.5 samples for each patient. PatientsPSAprogression

11.  In the Eastern region of SA:  PSA screening of 1192  6.9 % indicated for TRUS Bx  Only 75 % agreed for Bx  CA in 14 only = 1.17%

12.  In the western region:  Out of 45 patients underwent TRUS guided biopsy; cancer of the prostate was detected in 13 (28.8%).

13.  7.6%  in patients presented with abnormal DRE alone  15.3%  in the group with elevated PSA but normal DRE (stage T1c).

14.  21.4%  PSA was elevated to 4-10 ng/ml  40%  PSA to10-20 ng/ml  100%  PSA > 20 ng/ml

15.  21.4%  PSA was elevated to 4-10 ng/ml  40%  PSA to10-20 ng/ml  100%  PSA > 20 ng/ml % of CA - - 1.64 % 2.44 % PSA ng/ml < 2.5 < 4 4-10 >10 % of pt 76.8 85 8.2 6.1

16. All patientsPatients to FM PSAno. % % < 4187186%16287.5 4 to < 101788.20%126.5 > or = 101326.05%115.9 2181100%18599.9

18.  Sensitivity of CA detection:  PSA between 4-10 vs <4 ng/mL:  79% for levels between 4 and 10 ng/mL.  11% at levels below 4 ng/mL

19.  In a large prospective screening study  47% among men with a PSA velocity > 0.75 ng/mL per year  11% among men with a PSA velocity < 0.75 ng/mL per year

20.  At KFSH & RC Jd  88 patients came back +ve for Prostate cancer.  84/2181 = 4%

21. عن معاذ بن جبل ، أنهم خرجوا مع رسول الله صلى الله عليه وآله وسلم عام تبوك... قال : " إنكم ستأتون غدا ، إن شاء الله عين تبوك ، وإنكم لن تأتوها حتى يضحى النهار ، فمن جاءها فلا يمس من مائها شيئا حتى آتي “ فجئناها ، وقد سبقنا إليها رجلان ، والعين تبض بشيء من ماء، فسألهما رسول الله :" هل مسستما من مائها شيئا؟ " فقالا : نعم.... قال لهما ما شاء الله أن يقول. ثم غرفوا بأيديهم من العين ، قليلا قليلا. حتى اجتمع في شيء ، ثم غسل رسول الله صلى الله عليه وسلم ، فيه وجهه ويديه. ثم أعاده فيها ، فجرت العين بماء كثير. فاستقى الناس. ثم قال رسول الله صلى الله عليه وسلم : " يوشك يا معاذ إن طالت بك حياة، أن ترى ما هاهنا قد ملئ جنانا ” مالك في الموطأ 331 والإمام مسلم في صحيحه 4327

22. By non By urologist age SD

23. No.% < 4 4-10 > 10 > 20

24. PSABy non Urologists by Urologists #%#% < 4 4-10 > 10 > 20

25. All patientsPatients to FMFrom out side PSAno. % %No.% < 4 4 to < 10 > or = 10 > or = 20