BACKGROUND: We studied the prevalence of lower urinary tract symptoms (LUTS) and the relationship between the International Prostate Symptom Score (IPSS), prostate specific antigen (PSA), and quality of life (QOL) issues in a prostate cancer screening population.
METHODS: Between 1994 and 2001, free prostate cancer screening was offered to the general population in conjunction with prostate cancer awareness week. Of the 2,677 patient visits, 1023 represented men at their initial presentation at our center. Sixty-two subjects were excluded due to having been previously screened elsewhere or who had incomplete data leaving a total of 961 patient presentations in our study group. The IPSS/QOL questionnaire was completed and the results analyzed along with obtained PSA levels.
RESULTS: Of the 961 men, 645 (67%) men had mild or no symptoms (IPSS = 0-7), 260 (27%) men had moderate symptoms (IPSS = 8-19), and 56 (6%) men had severe symptoms (IPSS = 20-35) at their initial presentation. PSA levels in the mild, moderate, and severe symptom groups were 1.6 ± 1.8 ng/ml, 1.9 ± 2.2 ng/ml, and 3.3 ± 6.8 ng/ml, respectively. There was a statistically significant difference in PSA between the mild and severe symptom groups (p < 0.0001), and also between the moderate and severe symptom groups (p < 0.0001). The differences in QOL scores for the mild, moderate, and severe symptom categories were statistically significant (p < 0. 0001), and there was a linear correlation (r = 0.6978) between the QOL and the IPSS.
CONCLUSIONS: A strong correlation between the IPSS, QOL, and PSA scores exists in the screening population. One third of men undergoing screening had moderate to severe LUTS at their initial presentation. QOL was significantly correlated with IPSS and PSA levels.