The digital rectal examination is a procedure where a physician feels the surface of the prostate with a gloved finger. The doctor is able to feel any lumps or hard areas on the prostate.
A PSA test checks for levels of prostate-specific antigen in the blood, with higher levels signaling potential cancer. As men age, the acceptable PSA level increases.
"Prostate cancer is the most common cancer in men, accounting for over 28,000 deaths yearly," said Jay Raman, M.D., associate professor of surgery. "Improvements in screening methodology and refinements in cancer care have contributed, in part, to a reduction in recent mortality rates."
An elevated PSA level or an abnormality found on the prostate during the digital rectal exam typically leads to the recommendation of prostate needle biopsy, the most accurate diagnostic technique. Elevated PSA levels have been shown to more accurately predict a positive cancer biopsy result than the rectal exam. The digital rectal exam has been considered less precise because of the variability in of who is administersing the test and the experience of that person, and the incorrect positives associated with noncancerous abnormalities.
Other studies have shown the PSA test to be more sensitive and specific than the digital rectal exam, especially at low PSA levels. However, no study to the researchers' knowledge has looked at the effectiveness of the digital rectal exam when compared to age-adjusted PSA levels.
Penn State Hershey researchers studied 806 men from September 2001 to December 2008 to see how the initial testing lined up with the results of their biopsies.
In the group of men studied, half had elevated PSA levels and 36 percent had an abnormal digital rectal exam (with or without an elevated PSA). The biopsy diagnosed 306 of the men as having prostate cancer. Of that number, 136 of the men had an abnormal digital rectal exam finding.
Most importantly, 43 of the 136 men who had an abnormal digital rectal exam showed a normal PSA level for their age. While 14 percent of all patients with prostate cancer had an abnormal digital rectal exam, 31 percent of these men had normal PSA levels for their age.
"It is important to acknowledge that age-specific PSA cutoffs contribute some limitations in prostate cancer screening," Raman said. "In particular, while age-specific thresholds increase the sensitivity in younger men, these same cutoff values lower the sensitivity in older men."
Because the acceptable PSA level is increased for older men, it is possible that prostate cancer is being missed if only the PSA test is used.
"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," Raman said.
Researchers published their findings in The Canadian Journal of Urology.
Other researchers are Ricardo Palmerola, M.D., and Nikolina Icitovic, M.D., students, Penn State College of Medicine; and Paul Smith, M.D., Vanessa Elliot, M.D., Carl T. Reese, M.D., Frank B. Mahon, M.D., Lewis E. Harpster, M.D., all of Division of Urology, Penn State Milton S. Hershey Medical Center.
Matthew Solovey | EurekAlert!
Novel chip-based gene expression tool analyzes RNA quickly and accurately
18.01.2018 | University of Illinois College of Engineering
Potentially life-saving health monitor technology designed by Sussex University physicists
10.01.2018 | University of Sussex
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy