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@ARTICLE{Krilaviciute:284605,
      author       = {A. Krilaviciute$^*$ and N. Becker$^*$ and J. Lakes and J.
                      P. Radtke and M. Kuczyk and I. Peters and N. N. Harke and J.
                      Debus$^*$ and S. A. Koerber and K. Herkommer and J. E.
                      Gschwend and V. H. Meissner and A. Benner$^*$ and P.
                      Seibold$^*$ and G. Kristiansen and B. Hadaschik$^*$ and C.
                      Arsov and L. Schimmöller and F. L. Giesel and G. Antoch and
                      M. Makowski and F. Wacker and H.-P. Schlemmer$^*$ and R.
                      Kaaks$^*$ and P. Albers$^*$},
      title        = {{D}igital {R}ectal {E}xamination {I}s {N}ot a {U}seful
                      {S}creening {T}est for {P}rostate {C}ancer.},
      journal      = {European urology oncology},
      volume       = {6},
      number       = {6},
      issn         = {2588-9311},
      address      = {Amsterdam},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2023-02025},
      pages        = {566-573},
      year         = {2023},
      note         = {#EA:C130#LA:C130#LA:C020# / 2023 Dec;6(6):566-573},
      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.},
      keywords     = {Digital rectal examination (Other) / Prostate cancer
                      (Other) / Screening (Other)},
      cin          = {C130 / E050 / C060 / ED01 / E010 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C130-20160331 / I:(DE-He78)E050-20160331 /
                      I:(DE-He78)C060-20160331 / I:(DE-He78)ED01-20160331 /
                      I:(DE-He78)E010-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37806841},
      doi          = {10.1016/j.euo.2023.09.008},
      url          = {https://inrepo02.dkfz.de/record/284605},
}