Toward prostate cancer early detection in Iran.

BACKGROUND

The aim of this study was to document the epidemiological features of prostate cancer in Iran and to define its public health priorities for an early detection program.

METHODS

A review of published articles from 1975 to October 2008 was conducted using different search engines and 147 Persian medical journals. Abstracts only were excluded. Inclusion criteria were studies on prostate cancer clinical and epidemiological data.

RESULTS

In all, 40 full texts, 7 national reports, and 10 provincial reports were accessed. The incidence rate of prostate cancer was 9.6 (3.2 to 16.0) per 100,000 in multi geographical settings. The crude prostate cancer mortality rate was 4.5 per 100,000 in 2004. The prevalence of prostate cancer among patients with benign prostate hyperplasia (BPH) presentation was 6.3%. The overall prostate cancer detection rate was reported 3.6% in male over 40 years old by population screening programs.

CONCLUSION

The rate of prostate cancer incidence in Iran is significantly less than those in developed countries and similar to Eastern Mediterranean Regions. However, it is expected to rise dramatically in the future because of the anticipated increase in life expectancy and percentage of old age groups. Therefore, prostate cancer control should be integrated into the National Cancer Control Program focusing on prevention and early detection in men over 40 years old or with symptomatic BPH. An appropriate PSA cut off point for screening should be defined by population pilot studies.