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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...
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Published in: | Life (Basel, Switzerland) Switzerland), 2024-11, Vol.14 (11), p.1359 |
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description | 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. |
doi_str_mv | 10.3390/life14111359 |
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< 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.</description><identifier>ISSN: 2075-1729</identifier><identifier>EISSN: 2075-1729</identifier><identifier>DOI: 10.3390/life14111359</identifier><identifier>PMID: 39598158</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>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</subject><ispartof>Life (Basel, Switzerland), 2024-11, Vol.14 (11), p.1359</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c467t-6f5368e8389e33ab8ca95153a3cf538626497b779339df36306375085af80d0d3</cites><orcidid>0000-0001-6049-8697 ; 0000-0001-8374-6593</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3133140170/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3133140170?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39598158$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morote, Juan</creatorcontrib><creatorcontrib>Paesano, Nahuel</creatorcontrib><creatorcontrib>Picola, Natàlia</creatorcontrib><creatorcontrib>Muñoz-Rodriguez, Jesús</creatorcontrib><creatorcontrib>Ruiz-Plazas, Xavier</creatorcontrib><creatorcontrib>Muñoz-Rivero, Marta V</creatorcontrib><creatorcontrib>Celma, Ana</creatorcontrib><creatorcontrib>García-de Manuel, Gemma</creatorcontrib><creatorcontrib>Miró, Berta</creatorcontrib><creatorcontrib>Abascal, José M</creatorcontrib><creatorcontrib>Servian, Pol</creatorcontrib><creatorcontrib>Méndez, Olga</creatorcontrib><creatorcontrib>Trilla, Enrique</creatorcontrib><title>The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging</title><title>Life (Basel, Switzerland)</title><addtitle>Life (Basel)</addtitle><description>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.</description><subject>Biopsy</subject><subject>Digital imaging</subject><subject>digital rectal examination</subject><subject>early detection</subject><subject>Education</subject><subject>Effectiveness</subject><subject>Family medical history</subject><subject>FDA approval</subject><subject>Magnetic resonance imaging</subject><subject>Medical examination</subject><subject>Medical imaging</subject><subject>Medical screening</subject><subject>Methods</subject><subject>Mortality</subject><subject>Performance evaluation</subject><subject>Prediction models</subject><subject>Prostate cancer</subject><subject>Prostate-specific antigen</subject><subject>Rectum</subject><subject>Regression analysis</subject><subject>Urology</subject><issn>2075-1729</issn><issn>2075-1729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptksFu1DAQQCMEolXpjTOyxAUkttixndgnVG0XWKkItC1na9axU1eJ3dpe1F75cpxuqXYRyWGsmTfPyWiq6jXBJ5RK_HFw1hBGCKFcPqsOa9zyGWlr-XznfFAdp3SNy9Nw0gj2sjqgkktBuDisfl9eGbQKg0HBojPXuwwDWhk9hcUdjM5DdsEjGyJaQBzu0ZnJpTzlSseF672zToPP6EcMKUM2aA5em4icR7nIFxEm8hv03mSnizwFPxFoOULvfP-qemFhSOb4MR5VPz8vLudfZ-ffvyznp-czzZo2zxrLaSOMoEIaSmEtNEhOOAWqS0U0dcNku25bWQbTWdpQ3NCWY8HBCtzhjh5Vy623C3CtbqIbId6rAE49JELsFcTyhYNRtWC8bmrdiTVjQsh1Z7DUmBBRUjUTxfVp67rZrEfTaeNzhGFPul_x7kr14ZcihEvOsCyGd4-GGG43JmU1uqTNMIA3YZMUJZQyLuoaF_TtP-h12ERfZvVAEYZJu0P1UP7AeRvKxXqSqlNBBKWiZW2hTv5Dlbczo9PBG-tKfq_h_V5DYbK5yz1sUlLLi9U--2HL6rIKKRr7NBCC1bSvandfC_5md4hP8N_tpH8A5ELh4Q</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Morote, Juan</creator><creator>Paesano, Nahuel</creator><creator>Picola, Natàlia</creator><creator>Muñoz-Rodriguez, Jesús</creator><creator>Ruiz-Plazas, Xavier</creator><creator>Muñoz-Rivero, Marta V</creator><creator>Celma, Ana</creator><creator>García-de Manuel, Gemma</creator><creator>Miró, Berta</creator><creator>Abascal, José M</creator><creator>Servian, Pol</creator><creator>Méndez, Olga</creator><creator>Trilla, Enrique</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P64</scope><scope>PATMY</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6049-8697</orcidid><orcidid>https://orcid.org/0000-0001-8374-6593</orcidid></search><sort><creationdate>20241101</creationdate><title>The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging</title><author>Morote, Juan ; 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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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39598158</pmid><doi>10.3390/life14111359</doi><orcidid>https://orcid.org/0000-0001-6049-8697</orcidid><orcidid>https://orcid.org/0000-0001-8374-6593</orcidid><oa>free_for_read</oa></addata></record> |
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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 |
title | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
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