Digital Rectal Exam Has Low Diagnostic Value for Prostate Cancer

FRIDAY, Jan. 26, 2024 (HealthDay News) -- Digital rectal examination (DRE) exhibits low diagnostic value as an independent test and supplementary measure to prostate-specific antigen (PSA) for detection of prostate cancer, according to a study published online Jan. 4 in European Urology Oncology.

Akihiro Matsukawa, from the Medical University of Vienna in Austria, and colleagues identified prospective studies simultaneously investigating the diagnostic performance of DRE and PSA for prostate cancer screening to assess the diagnostic value of DRE for early detection of prostate cancer. The positive predictive value (PPV) and cancer detection rate (CDR) of DRE were examined as primary end points.

Eight studies, including three randomized controlled trials and five prospective diagnostic studies, with 85,738 participants were identified, which reported PPV and CDR of both DRE and PSA for the same cohort. The researchers found that the pooled PPV was 0.21 for DRE, which was similar to the PPV of PSA (0.22), with no additional benefit for combining DRE and PSA (0.19). The CDR was significantly lower for DRE than PSA and the combination of DRE and PSA (0.01 versus 0.03 and 0.03, respectively). In terms of CDR and PPV, combining DRE and PSA was not significantly different to PSA alone.

"These findings suggest that DRE could be potentially omitted from prostate cancer screening and early detection in the absence of clinical symptoms and signs," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text