A study of Fine Needle Aspiration Cytology for detection of prostate cancer in low resource settings

Abstract

Objective: To assess the use of Fine Needle Aspiration cytology as a low resource tool for the early detection of Prostate Cancer in these setting.

Methods: All patients presenting to Ndola Central Hospital  with elevated PSA  and a clinical diagnosis of Cancer of the Prostate were recruited in the study. These patients had FNAC and true cut biopsy  of the Prostate using trans-rectal route. The procedure used a Finger Guided technique which is the most commonly used method in low resourced settings. The histology result was taken as the gold standard and the sensitivity, specificity and accuracy of FNAC was compared . In line with Royal College of Pathologist guidelines if the sensitivity and specificity exceeded 60% this was considered acceptable.

Results: A total of 23 patients were recruited in the study. There average age was 65.8 years. The age range was 53 to 83 years.  The PSA ranged from 11 to 100ng/ml  and the mean PSA was 20ng/ml. There were 3(13%) diagnosed as benign by histopathology while 20 (87%) were diagnosed as malignant. From cytology 1( 4.3%) was inadequate, while 5 (21.7%) were benign and  17(74%) were malignant. The sensitivity of FNAC was 80% and the specificity was 75%. The FNAC had an patient and provider acceptability of 90%.

Conclusion: This small pilot study shows a high acceptability of 90% by providers and patients for FNAC for the diagnosis of Cancer of the prostate in a low resource setting. The study also found that FNAC had a sensitivity of 80% and a specificity of 67%.