Journal Article

DKFZ-2023-02025

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Digital Rectal Examination Is Not a Useful Screening Test for Prostate Cancer.

Krilaviciute, A. (First author)DKFZ* ; Becker, N. (First author)DKFZ* ; Lakes, J. ; Radtke, J. P. ; Kuczyk, M. ; Peters, I. ; Harke, N. N. ; Debus, J.DKFZ* ; Koerber, S. A. ; Herkommer, K. ; Gschwend, J. E. ; Meissner, V. H. ; Benner, A.DKFZ* ; Seibold, P.DKFZ* ; Kristiansen, G. ; Hadaschik, B.DKFZ* ; Arsov, C. ; Schimmöller, L. ; Giesel, F. L. ; Antoch, G. ; Makowski, M. ; Wacker, F. ; Schlemmer, H.-P.DKFZ* ; Kaaks, R. (Last author)DKFZ* ; Albers, P. (Last author)DKFZ*

2023
Elsevier Amsterdam

This record in other databases:  

Please use a persistent id in citations: doi:10.1016/j.euo.2023.09.008

Abstract: Annual digital rectal examination (DRE) is recommended as a stand-alone screening test for prostate cancer (PCa) in Germany for 45+ yr olds. DRE diagnostic performance in men as young as 45 yr old has not been proved by a screening trial.To determine DRE diagnostic performance in a screening trial.This analysis was conducted within the multicentric, randomized PROBASE trial, which enrolled >46 000 men at age 45 to test risk-adapted prostate-specific antigen (PSA) screening for PCa.(1) DRE was analyzed as a one-time, stand-alone screening offer at age 45 in 6537 men in one arm of the trial and (2) PCa detection by DRE was evaluated at the time of PSA-screen-driven biopsies (N = 578).(1) True-/false-positive detection rates of DRE as compared with PSA screening and (2) DRE outcome at the time of a prostate biopsy were evaluated.(1) A prospective analysis of 57 men with suspicious DRE at age 45 revealed three PCa. Detection rate by DRE was 0.05% (three of 6537) as compared with a four-fold higher rate by PSA screening (48 of 23 301, 0.21%). The true-positive detection rate by DRE relative to screening by PSA was 0.22 (95% confidence interval [CI] = [0.07-0.72]) and the false-positive detection rate by DRE was 2.2 (95% CI = [1.50-3.17]). (2) Among PSA-screen-detected PCa cases, 86% had unsuspicious DRE (sensitivity relative to PSA was 14%), with the majority of these tumors (86%) located in the potentially accessible zones of the prostate as seen by magnetic resonance imaging.The performance of stand-alone DRE to screen for PCa is poor. DRE should not be recommended as a PCa screening test in young men. Furthermore, DRE does not improve the detection of PSA-screen-detected PCa.Our report demonstrated the poor diagnostic performance of digital rectal examination in the screening for prostate cancer in young men.

Keyword(s): Digital rectal examination ; Prostate cancer ; Screening

Note: #EA:C130#LA:C130#LA:C020# / 2023 Dec;6(6):566-573

---

Contributing Institute(s):

1. Personalisierte Früherkennung des Prostatakarzinoms (C130)
2. E050 KKE Strahlentherapie (E050)
3. C060 Biostatistik (C060)
4. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)
5. E010 Radiologie (E010)
6. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2023

---

Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---