With the rising trend of prostate cancer, where does northern Sri Lanka stand? A cohort study from a tertiary care centre.

Introduction: Prostate cancer is the second most common cancer among males all over the world in 2020. As per the global cancer observatory 1, 414, 259 (7.3%) cases were diagnosed in 2020 worldwide. The study aims to analyse the variations in demographic and clinico-pathological characteristics of prostate cancer in the Northern Province. Methods: This is a cross-sectional descriptive institution-based study that recruited all the prostate cancer patients who were treated at the Teaching hospital, Jaffna from August 2019 to August 2022. Data were extracted retrospectively from the clinic records of the patients as well as histopathology documents. Results: A total of 141 diagnosed patients at Teaching Hospital Jaffna were analysed. The mean age of the sample was 70.11± 8.43 years. Out of 141 patients, 30.49% were diagnosed to have localized disease and 26.24% and 43.26% with locally advanced and metastatic disease respectively. Out of those who had localized disease 68.5% were managed with radiotherapy, 23.25% with active surveillance and 11.6% with radical prostatectomy. The mean value of PSA was 70.11±8.4. The majority 97.2% had small acinar adeno carcinoma as histology. As per the D’Amico classification system for prostate cancer, 2.83% belonged to low-risk category and 80.1% belonged to high-risk category. Conclusion: There is a rising trend in the incidence of prostate cancer in Sri Lanka over the recent past. Most of the cases are advanced at the initial presentation. It implies the need for screening programmes with PSA in near future to detect cancer at early stages, implementation of cancer awareness programmes as practised in Western countries and strict adherence to national guidelines on management and referral pathways.