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Year : 2015  |  Volume : 18  |  Issue : 2  |  Page : 61-67

Accuracy of clinical diagnosis of prostate cancer: Implications for patients' management

1 Department of Histopathology, Nnamdi Azikiwe University, Awka, Anambra, Nigeria
2 University of Port Harcourt, Rivers State, Nigeria

Correspondence Address:
Dr. Michael Emeka Onwukamuche
Department of Histopathology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nnewi, Anambra
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DOI: 10.4103/1119-0388.158396

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Background: Cancer of the prostate is the commonest cancer and the most frequent cause of cancer deaths in Nigerian males. In Nigeria, prostate cancer patients frequently present in the late stage of the disease with consequent poor prognosis. The outcome of the disease in our setting is also worsened by diagnostic errors; this fact has been underappreciated. In this study, we have assessed the accuracy of clinical diagnosis of prostate tumors by clinicians working in Anambra State, Nigeria. Materials and Methods: Retrospective data were retrieved for all histopathology requests for prostatectomy specimens submitted to three pathology laboratories in Anambra State, Nigeria. The working clinical diagnoses were compared with the corresponding histopathology diagnoses, and the diagnostic accuracy of the medical doctors was calculated statistically. Results: Our results showed that the clinicians studied have a low overall sensitivity (37,500 per 100,000 patients) in diagnosing prostate cancer. Furthermore, doctors working in public hospitals have a slightly lower sensitivity but higher specificity than doctors serving in private hospitals when it comes to diagnosing prostrate tumors. Conclusion: This study revealed a high specificity but low sensitivity in clinicians' ability to accurately diagnose prostatic cancer. Reliance on PSA needs to be reviewed. More so the serving laboratories in the index State may need to apply internal and external quality assurance systems to their PSA analysis. It will be instructive to search for other diagnostic tools with appreciably higher predictive value. Generally, more education, research and development is needed for improvement.

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