294P - Over diagnosis of prostate cancer in Eurasian men by PSA and PHI: example of heterosis

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Prostate Cancer
Aetiology, Epidemiology, Screening and Prevention
Presenter Yingqiu Xie
Citation Annals of Oncology (2016) 27 (suppl_9): ix90-ix93. 10.1093/annonc/mdw584
Authors Y. Xie1, E.E. Iskakova2, Q. Yang1, N. Sakenova1, Y. Chen3, Z.T.H. Tse4, Y. Huang5, S. Wu5
  • 1Department Of Biology, Nazarbayev University, 010000 - Astana/KZ
  • 2Module Of Pathological Anatomy, Kazakh National Medical University, 050000 - Astana/KZ
  • 3Engineering, Vanderbilt University, 37212 - Nashville/US
  • 4College Of Engineering, University of Georgia, 30602 - Athens/US
  • 5Department Of Urology, Shenzhen University Luohu Hospital; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, 518001 - Shenzhen/CN



Prostate-Specific Antigen (PSA) and prostate health Index (PHI) which combines PSA, free PSA and p2PSA has been applied in clinics but the accuracy in Kazakhstan patients are largely unknown. Due to long history of migration between Asia and Europe, Kazakhstani men may have the heterosis genetic background and super elevation of PSA or PHI which may not be linked to cancer.


We recruited 222 male aged 50-66 to test PSA levels in 2015 in Kazakhstan. Chi-square, Pearson's and Spearman's correlations were calculated.


We found 91.45% patients showed super-high PSA levels more than 4ng/ml ranging from 4-20 ng/ml and only 8.55% patients (19 individual) showed lower PSA level ranging from 1.7 to 3.9 ng/ml. 17 patients with PSA levels less than 4ng/ml have no prostate cancer. Only 25.68% patients with PSA over 4ng/ml have cancer with Gleason score ranging from 6-8. Majority of patients (65.77%) have no cancer. Moreover, very few patients (2 cases) showed PSA lower than 4ng/ml but with cancer. PHI, the new method of detecting 3 forms of PSA, is also not correlated to adenocarcinoma (P = 0.4301). In patients with PHI>27ng/ml, 87.5% patient have no adenocarcinoma; while PHI


Kazakhstani men may have higher levels of PSA than 4ng/ml but no adenocarcinoma. The PSA and PHI screening generated false positive rate is much higher than the correct positive diagnosis. In this cohort study, it is estimated that only one quarter of patients can get benefit from the PSA screening to predict the cancer. Heterosis in Eurasian men but not cancer might be related to the hyper-expression of PSA which causes the large scale over diagnosis. Our data suggest that unique diagnosis markers are urgently need for predication and avoiding biopsy for Eurasian men.

Clinical trial indentification


Legal entity responsible for the study

Elzira E. Iskakova




All authors have declared no conflicts of interest.