Digital rectal examination not useful for screening prostate cancer in young men

The key findings of the study are:

• A prospective analysis of 57 men with suspicious DRE at age 45 revealed three PCa.
• The rate of Detection by DRE was 0.05% (three of 6537) compared to a four-fold higher rate by PSA screening (48 /23 301, 0.21%).
• The true-positive detection rate by DRE relative to screening by PSA was 0.22.
• The false-positive detection rate by DRE was 2.2.
• Among PSA-screen–detected PCa cases, 86% had unsuspicious DRE. The sensitivity relative to PSA was 14%.
• 86 % of these tumours were located in the potentially accessible zones of the prostate, as seen by MRI.

Researchers from the German Cancer Research Center said, “In our study, we found that performance of stand-alone DRE for Prostate cancer screening is poor.”

They mentioned in young men, DRE should not be recommended as a PCa screening test. Furthermore, DRE does not improve the detection of PSA-screen–detected PCa.

Reference:

Krilavičiūtė, A., Becker, N., Lakes, J., Radtke, J. P., Kuczyk, M. A., Peters, I., Harke, N., Debus, J., Koerber, S. A., Herkommer, K., Gschwend, J. E., Meissner, V. H., Benner, A., Seibold, P., Kristiansen, G., Hadaschik, B., Arsov, C., Schimmöller, L., Giesel, F. L., . . . Albers, P. (2023). Digital rectal examination is not a useful screening test for prostate cancer. European Urology Oncology. https://doi.org/10.1016/j.euo.2023.09.008