Clinicopathological Characteristics of Prostate Cancer in Tlemcen (Northwestern Algeria)

Abstract

Background: Prostate cancer is the main cause of cancer death in men in about 48 countries, including several sub-Saharan African, Caribbean, Central and South American countries. Despite the prevalence of prostate cancer, little is known about its etiology. Limited data exist for North Africa, and Algeria in particular, at the crossroads of Sub-Saharan Africa, the Middle East, southern Europe, and the Mediterranean region.

Objective: This study aimed to determine the relationship between a family history of cancer and age at diagnosis, and to assess the effect of a family history of cancer and prostate-specific antigen (PSA) levels on tumor prognosis.

Methods: This cross-sectional study was conducted on the records of 184 patients with prostate cancer confirmed by biopsy, diagnosed between 2011 and 2016 at the Urology Division of Tlemcen’s teaching hospital. The collected data included the age at diagnosis, PSA level on presentation, Gleason score on biopsy, and a family history of cancer. Univariate statistical analyses were performed using ANOVA, independent-samples t-test, and Fisher's exact test in Minitab® 17.

Results: Men who had first-degree female relatives with breast cancer had a younger mean age at diagnosis (67.31 y) than those who did not have the same family history (72.3 y) (p=0.02). Positive first-degree family history for prostate cancer was associated with favorable tumor prognosis (Gleason ≤ 6) at the time of diagnosis (p<0.001). There was also a significant moderate positive correlation (Pearson correlation = 0.35) between PSA level and Gleason score (p<0.001).

Conclusion: Our data suggest an association between positive first-degree family history for breast/prostate cancer and the age of onset. Positive first-degree family history for prostate cancer appears to predict a favorable tumor prognosis. The Gleason score seems to rise with the PSA level. Men with a family history of prostate/breast cancer might start prostate cancer screening earlier than those without the same family history.

This study raises several questions that need to be addressed in future research. Prospective cohort studies would help identify and assess ethnic, genetic, hormonal, and environmental risk factors, and investigate the interactions influencing the genesis of this cancer, thereby guiding public health plans for cancer control and intervention strategies (screening, treatment, and survivor care).