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For screened patients with a PSA level between 4.1 and 10.0?ng/mL, PSA density (PSAD)2 was calculated as PSA divided by PV. When screened patients had positive DRE or positive TRUS or a PSA value greater than 10.0?ng/mL, prostate biopsy was routinely carried out. For a screened patient who had a PSA level from 4.1 to 10.0?ng/mL, and negative DRE and TRUS findings, a biopsy was indicated only when his PSAD was greater than 0.15. For screened patients with a negative DRE, negative TRUS and PSAD equal to or less than 0.15, consecutive annual prostate screening participation was recommended. The same indication was applied for the repeat biopsy. For those indicated for prostate biopsy, transperineal prostate biopsy was carried out under local anesthesia. http://www.selleckchem.com/products/gsk2126458.html Systematic sextant biopsy technique was applied between 1995 and 2001. Since 2002, an additional sample http://www.selleckchem.com/products/bay-57-1293.html has been taken from the far lateral region in each lobe (systematic octant biopsy). Because this screening system was established in 1995, free to total PSA ratio and high-grade prostatic intraepithelial neoplasia (HGPIN) or atypical small acinar proliferation (ASAP) on the initial biopsy were not considered to indicate repeat biopsy for patients with a negative initial biopsy. Consequently, age and PV at initial biopsy, DRE findings, TRUS findings, serum PSA levels, and PSAD values at the initial and latest biopsies, as well as the time interval and PSA velocity (PSAV) between the initial and latest biopsies were evaluated as predictors for positive repeat biopsy. Similar to the definition by Etzioni et?al.,3 PSAV was defined as an absolute increase in PSA level per year from the initial biopsy to the latest biopsy. Therefore, if a patient underwent biopsies three times or more, and cancer was detected at the latest biopsy, PSAV was calculated using PSA values at the initial and latest biopsies. Additionally, if the PSA level at the latest measurement was lower than the initial one, PSAV was recorded as a negative value. Analyses were carried out with JMP 8 software (SAS Institute, Cary, NC, USA). We used Wilcoxon rank-sum test to compare a continuous variable within two populations. http://www.selleck.cn/products/CAL-101.html For categorical parameters, Fischer's exact test was applied. P?