Mass screening of prostate cancer in Vietnam: current status and our opinions.

Background: Although prostate cancer (CaP) is the most common male cancer in developed countries, the incidence of CaP in Vietnam remains unknown and the patients often seek treatment at a late stage in their illness. The mass screening of CaP, which has been performed since Jan 2008 in Binh Dan hospital (Ho Chi Minh City) aims to evaluate the effect of CaP mass screening in Vietnam. The details of CaP treatment from 1999 to now in Ho Chi Minh City (HCMC) were also used for evaluation and comparison.

Materials And Methods: From the first quarter of 2008, we started a free CaP screening program in HCMC. There were 408 cases during first round of results. When inspecting CaP treatment, all papers and studies of CaP at Binh Dan hospital from 1999 were analyzed, including 1,775 CaPs treated.

Results And Discussions: A total of 408 subjects were screened during the CaP program. Prostate biopsies were carried out on 87 men (21.3%) based on PSA values and DRE results. Ten of these biopsied men (2.5%) were diagnosed with CaP, mostly with Gleason's scores of 5 to 7 and in an early clinical stage. In reviewing CaP treatment from 1999 to 2009, complete androgen blockade/maximal androgen blockade (MAB/CAB) was widely used, while chemotherapy and radiotherapy were not routinely used. Open and laparoscopic total prostatectomy remarkably increased due to the many efforts of CaP screening. The number of CaP cases has now reached and overtaken the number of bladder cancer cases in our hospital. Similarly, early diagnosis rates have increased in parallel with radical treatment.

Conclusion: Our initial outcomes reflected a low prevalence of CaP in general (2,5%), but a high occurrence of medium grade lesions (Gleason 7) among patients who tested positive for CaP. On one hand, this observation highlights the value of the CaP screening programs in alerting doctors/people and detecting more cases in the early stages of development. On the other hand, the benefit of a mass screening program for CaP is not proven. Meanwhile, selective CaP screening takes advantage of diagnosis and treatment in our country.