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Prostatic intraepithelial neoplasia (PIN) is a precancerous condition that often leads to prostate cancer. Screening procedures like PSA and DRE are unable to detect it. Low-grade PIN requires follow-up, while high-grade PIN requires monitoring every six months and a repeat biopsy. About 30% of men with high-grade PIN may be diagnosed with prostate cancer during a repeat biopsy.
The prostate gland, part of the man’s reproductive system, mainly produces fluid that nourishes sperm cells. When prostate cells undergo abnormal changes, this often results in prostate disorders. One of them is known as prostatic intraepithelial neoplasia (PIN). This condition is generally considered to be a precancerous condition, meaning it has a tendency to develop into prostate cancer. Prostate cancer is prevalent among older men.
Prostate cancer screening procedures such as prostate-specific antigen (PSA) blood testing and digital rectal examination (DRE) are usually unable to detect the presence of prostatic intraepithelial neoplasia. Most men with this condition develop no symptoms. This abnormality in the prostate gland is frequently found during a biopsy or removal of prostate gland tissue, due to other reproductive problems, such as benign prostatic hyperplasia (BPH). BPH usually occurs when there is an enlargement of the prostate gland. Men with this condition often experience frequent urination and disruption of urine flow.
Prostate tissue from a biopsy is processed in a laboratory and analyzed by a pathologist for the presence of abnormalities. Pathologists are experts at studying blood and tissue to determine the cause of disease. When prostatic intraepithelial neoplasia is found, it is then described as low-grade or high-grade, depending on how it looks compared to normal cells. This categorization is also often important in patient management.
In low-grade prostatic intraepithelial neoplasia, the appearance of abnormal cells is only slightly different from that of the normal prostate. Most urologists, doctors who treat men with reproductive organ disorders, can ask patients to have another checkup and a biopsy a year later for follow-up. Studies have indicated that approximately 16% of low-grade PIN can lead to prostate cancer.
Men diagnosed with high-grade prostatic intraepithelial neoplasia, however, are often managed differently. This is because abnormalities in cell appearance are usually more pronounced in high-grade prostatic intraepithelial neoplasia. Monitoring of patients is commonly done every six months, when they may have a PSA test, a DRE, and a repeat prostate biopsy.
It is estimated that about 30% of men with high-grade prostatic intraepithelial neoplasia may be diagnosed with prostate cancer during a repeat biopsy. If no cancer is found after the first two years of regular checkups, patients are usually scheduled to visit once a year. When cancer is found, appropriate treatment is then given.
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