Differentiating Prostate Cancer from Benign Prostatic Hyperplasia Using PSAD Based on Machine Learning: Single-Center Retrospective Study in China

The incidence of prostate cancer increases annually. Prostate cancer is an underreported and emerging problem in China. We conducted a cross-sectional study of 392 eligible patients from 710 men with prostate cancer or benign prostatic hyperplasia between 2000 and 2003. For total prostate-specific antigen, age, three diameters of prostate, prostate volume and prostate-specific antigen density seven indices, analysis of variance, and t test were used to analyze the difference between the groups. A decision tree with pruning was established using the prostate-specific antigen density, age, and transversal diameter of the prostate to screen the patient with prostate cancer. According to the established decision tree model, prostate-specific antigen density was the most important factor affecting the occurrence of prostate cancer. In elderly people over the age of 83 years, the transverse diameter of prostate cancer was smaller than that of benign prostatic hyperplasia, with prostate-specific antigen density less than 0.49 ng/L². No additional index was introduced, and the detection rate of prostate cancer was 86.6 percent. The specificity was enhanced to 78.1 percent.