March 9, 2023 – Every every now and then, recent research results emerge that query the standard standard of care in medicine. In this case, a study from Germany raises doubts in regards to the usefulness of digital rectal examinations for detecting prostate cancer, especially within the early stages.
The researchers enrolled 46,495 men within the PROBASE study between 2014 and 2019 who were screened for prostate cancer at age 45. Half of the boys were offered a digital rectal examination (DRE), by which a health care provider uses a finger to look at the prostate for lumps or unusual swellings. This was followed by a Prostate-specific antigen Blood test 5 years later at age 50. The other half were only offered the PSA test at age 45.
Lead researcher Dr. Agne Krilaviciute and her colleagues found that the PSA test detected 4 times as many cases of early prostate cancer as a digital rectal examination alone.
“One of the main reasons for prostate cancer screening is to detect it in patients as early as possible,” said Krilaviciute, a researcher on the German Cancer Research Center in Heidelberg, in a press release. “Our study suggests that the DRE is simply not sensitive enough to detect these cancers at an early stage.”
The researchers suggest that other methods reminiscent of PSA tests and MRI scans ought to be used as an alternative of digital rectal examinations for prostate cancer screening in men. The results were presented on the annual congress of the European Association of Urology in Milan.
Of the 23,194 people within the delayed PSA test group, 6,537 underwent a rectal examination. Within this group, 57 people had suspicious findings and underwent a biopsy, and three of them were diagnosed with prostate cancer.
“We speculate in our article that the DRE is just not only not suitable, Cancerhowever it can also be a reason why people don't come for screening – the test probably puts many men off,” says Krilaviciute. “In Germany, for instance, the participation rate within the screening program for men between 45 and 50 years of age is lower than 20 percent. If we offered a PSA test as an alternative, perhaps more of them can be willing to return.”