Digital Exams Beat PSA at Catching Prostate Cancer

Wednesday, 20 Mar 2013 04:21 PM

By Nick Tate

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Digital rectal exams are more effective at detecting prostate cancer than prostate-specific antigen (PSA) tests, despite the higher sensitivity of the lab check, a new study shows.

The findings, published in the Canadian Journal of Urology, are based on an analysis by Penn State College of Medicine researchers of 806 men to determine how the initial prostate testing — either a PSA test or DRE — lined up with the results of their biopsies.

Half the men studied had elevated PSA levels, a potential marker for cancer. About 36 percent had an abnormal DRE — a procedure where a physician feels the surface of the prostate with a gloved finger for lumps or hard areas that might indicate tumors.

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The researchers found biopsies indicated 306 of the men had prostate cancer. Of that number, 136 had an abnormal DRE. But the results also showed 43 of the 136 men with an abnormal DRE had a normal PSA level for their age. While 14 percent of all patients with prostate cancer had an abnormal DRE, 31 percent of these men had normal PSA levels for their age.
 
"Our study confirms that the digital rectal exam remains an important part of screening such patients because 31 percent of cancers in our study would have been missed by using age-specific PSA cutoffs alone," said Jay Raman, M.D., associate professor of surgery.
 
Raman noted prostate cancer is the most common cancer in men, accounting for 28,000 deaths a year.

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