The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging

The role of digital rectal examination (DRE) in the early detection of significant prostate cancer (PCa) is being questioned in the era of magnetic resonance imaging (MRI). However, some men with suspected PCa may still be identified solely through DRE, even with low serum prostate-specific antigen...

Full description

Saved in:
Bibliographic Details
Published in:Life (Basel, Switzerland) Switzerland), 2024-11, Vol.14 (11), p.1359
Main Authors: Morote, Juan, Paesano, Nahuel, Picola, Natàlia, Muñoz-Rodriguez, Jesús, Ruiz-Plazas, Xavier, Muñoz-Rivero, Marta V, Celma, Ana, García-de Manuel, Gemma, Miró, Berta, Abascal, José M, Servian, Pol, Méndez, Olga, Trilla, Enrique
Format: Article
Language:English
Subjects:
Biopsy
Digital imaging
digital rectal examination
early detection
Education
Effectiveness
Family medical history
FDA approval
Magnetic resonance imaging
Medical examination
Medical imaging
Medical screening
Methods
Mortality
Performance evaluation
Prediction models
Prostate cancer
Prostate-specific antigen
Rectum
Regression analysis
Urology
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The role of digital rectal examination (DRE) in the early detection of significant prostate cancer (PCa) is being questioned in the era of magnetic resonance imaging (MRI). However, some men with suspected PCa may still be identified solely through DRE, even with low serum prostate-specific antigen (PSA) levels. Additionally, most predictive models designed to improve significant PCa diagnostic pathways incorporate DRE findings. We assessed the role of DRE among 5005 men with serum PSA levels > 3.0 ng/mL and/or suspicious DRE findings, who underwent pre-biopsy MRI and targeted and/or systematic biopsies, as part of the significant PCa opportunistic screening program in Catalonia (Spain) between 2016 and 2023. Significant PCa, defined as grade group > 2, was detected in 2097 men (41.9%). Suspicion of PCa was based solely on DRE in 206 cases (4.1%) with significant PCa detected in 50 of them (2.4%). Two pathways using the Barcelona predictive models, before and after MRI, with and without DRE findings showed specificities of 52.8 and 38.7%, respectively ( < 0.001), after fixing sensitivity at 90%. Prostate biopsy was avoided in 35.1 and 26.7%, respectively ( < 0.001), while its efficacy increased from 52.8 to 58%. We conclude that DRE improved the effectiveness of an opportunistic significant PCa-screening program.
ISSN:2075-1729
2075-1729
DOI:10.3390/life14111359