Evaluation of Ionized Calcium as a Potential Biomarker for Benign Prostate Hyperplasia and Prostate Cancer in a Nigerian Population

Background/Objectives Benign prostate hyperplasia and prostate cancer are prostate disorders that have continued to pose major concerns among adult men. Prostate-specific antigen (PSA) determination is inadequate to differentiate these conditions, as it is raised in both conditions. Also, most often, high levels are seen in cases already established with clinical signs or symptoms of prostate complications. Serum calcium, which can exist in the ionized and non-ionized form, has been postulated to increase the risk of prostate cancer. There is an urgent need for further evaluation of ionized calcium as a prospective biomarker for prostate disorders; hence, this study aims to evaluate the potential use of ionized calcium as a marker of benign prostate hyperplasia and prostate cancer. Methods A total of 138 consenting male subjects, 50 years and above, diagnosed with prostate cancer (70 subjects) or benign prostatic hyperplasia (BPH) (68 subjects), attending the urology clinic, and another 69 non-prostate diseased subjects of the same age group from the general clinic as negative controls, were recruited randomly from Lagos University Teaching Hospital, Idi-Araba for this prospective cross-sectional study. After calculating the sample size based on a previous local prevalence rate of 7.9%, a total of 5 mL of venous blood was collected from all participants and dispensed into appropriate specimen containers. Serum and plasma were obtained using standard techniques; thereafter, ionized and total calcium, as well as free and bound PSA, were determined using standard methods. The data generated were subjected to statistical analysis using SPSS version 28, with a P < .05 considered significant. Results The mean serum concentration of total PSA, free PSA, serum ionized calcium and total calcium levels among adult males with benign prostate hyperplasia and prostate cancer were significantly higher than those of the control group. A positive correlation was found between total calcium and total PSA ( P < .05). Additionally, ionized calcium showed a strong and positive correlation with both total and free PSA ( P < .000). Also, ionized calcium demonstrated a sensitivity of 62.5% compared to the current gold standard for PSA, which is 71.1%, and a better negative predictive value of 47.1% compared to total PSA’s 32.4%. Conclusion Ionized calcium, therefore, is a potential biomarker for early detection of prostate cancer and could serve as a better predictor for future prostate cancer. It is recommended that ionized calcium be added to the screening tests for all men aged 50 years to monitor for early development of prostate disorders, particularly prostate cancer.