Determining the Sensitivity of Transrectal Ultrasonography on a Consecutive Series of Prostate Cancers in a Clinical and Screening Setting

Purpose To evaluate the sensitivity at transrectal ultrasonography (TRUS) for prostate cancer. Material A consecutive series of 170 prostate cancers identified by matching local cancer registry and TRUS archives at the Centro per lo Studio e la Prevenzione Oncologica of Florence. Method TRUS sensitivity was determined as the ratio of TRUS positive to total prostate cancers occurring at different intervals from TRUS date. Univariate and multivariate analyses of sensitivity determinants were performed. Results Sensitivity at 6 months, 1, 2 and 3 years after the test was 94.1% (95% Cl, 90-98), 89.8% (95% Cl, 85-95), 80.4% (95% Cl, 74-87) and 74.1% (95% Cl, 68-81%), respectively. A higher sensitivity (statistically significant) of TRUS was observed only if digital rectal examination was suspicious, whereas no association to sensitivity was observed for age, prostate-specific antigen or prostate-specific antigen density. Conclusions The study provided a reliable estimate of TRUS sensitivity, particularly reliable being checked against a cancer registry: observed sensitivity was high, at least of the same magnitude of other cancer screening tests. TRUS, which is known to allow for considerable diagnostic anticipation and is more specific than prostate-specific antigen, might still be considered for its contribution to a screening approach.