Preliminary Analysis of Prostate Cancer Screening Results and Exploration of Screening Model for Elderly Males in Rural Areas of Songjiang District, Shanghai.

[OBJECTIVES] To analyze prostate cancer (PCa) screening results using serum prostate-specific antigen (PSA) among elderly males in rural Songjiang District, Shanghai, and explore a suitable screening model for rural residents.

[METHODS] From June 2022 to June 2024, data was collected from Songjiang Hospital affiliated with Shanghai Jiaotong University School of Medicine and community health service centers in Shanghai's Songjiang District. This was achieved through free clinics and annual physical examination data, specifically targeting PSA screening among residents. For individuals with PSA levels ≥ 10 ng/mL and those with PSA levels between 4 and 10 ng/mL accompanied by an abnormal fPSA/tPSA ratio, prostate biopsy was suggested. The clinical characteristics of PCa patients were analyzed, and follow-up was conducted via telephone, combined with the family doctor visit model, along with enhanced publicity and education measures.

[RESULTS] Among 17 198 screened residents, 2491 (14.48%) had abnormal PSA levels. Ultimately, 417 underwent biopsy, confirming PCa in 171 residents (puncture positive rate: 41.00%). The overall PCa detection rate was 0.99%. Pathologically, PCa was primarily adenocarcinoma (98.24%). Among 146 diagnosed patients receiving treatment, the majority (84.93%) were medium or high-risk. Optimizing the screening model significantly increased outpatient visits proportion in the later period.

[CONCLUSION] PSA-based screening significantly increases PCa detection rates and can improve patient prognosis. The epidemiological profile indicates PCa patients in this rural area are predominantly medium and high-risk, underscoring the critical need for strengthened early screening and health education measures.