Prostate disease prevalence with epidemiological and hormonal analysis in randomly selected male population in Croatia.

The objective of our study was to investigate the prevalence of prostate disease in general male population. Also, an extended analysis of medical history, behavior and hormonal analysis was performed. 1000 candidates were randomly selected out of voluntary male population. 977 of those were included in the study, and 23 were rejected because of incomplete data, unwillingness to be subjected to examination and other reasons. Blood samples were taken from all participants, and a questionnaire and physical examination (with rectal exam) were performed. Based on the results, answers and the examination all participants were divided in four groups. The prevalence of benign prostate hyperplasia was 23.1%, of prostatitis 5.1% and of prostate cancer 3.7%, which is within expected reported values. Family history data provided little specific data. Significant lower urinary tract symptoms were found in both subjects with benign prostate hyperplasia and prostatitis, showing a strong overlap of symptoms. The results indicate that alcohol abuse is strongly related to subjects with prostate cancer, although this relation is not confirmed by all authors. On the hormonal scale we found higher levels of binned testosterone in our subjects with prostate cancer, what is disproved by some authors. Estrogen is found in higher levels and recent reports are showing higher levels of estrogen metabolites in prostate cancer subjects. Also we found lower levels of vitamin D in subjects with benign prostate hyperplasia and prostate cancer. Since vitamin D is known to inhibit cellular proliferation, lower levels are confirmatory, with its loss of protective role against prostate cancer. Our results suggest that male population in Croatia (at least in Slavonia) with prostate diseases is, with all findings taken into account, within limits as compared to populations in developed European countries, but on a lower border. Since the prevalence of investigated diseases is rising throughout Europe we could expect the same trends in our country.