Assessment of the value of the different variants of abnormal digital rectal examination finding in predicting carcinoma of the prostate: a preliminary report of a two-center study

Abstract

Background: Digital rectal examination is a veritable tool for the clinical diagnosis and screening for carcinoma of the prostate. This study aims to assess the value of the different variables which constitute abnormal digital rectal examination (DRE) findings. Results: Following ethical approval, one hundred and thirty-one men met the inclusion criteria and were enrolled in the study. The peak incidence of abnormal DRE finding was in the 8th decade of life, while the PPV was 66.5%. Of the total, 44 (33.5%) were nodular hyperplasia, 12 (9.2%) were prostate intra-epithelia neoplasia, while 75 (57.3%) were adenocarcinoma. With a positive predictive value (PPV) of 73.3%, a hard nodular feel was the only abnormal DRE finding that independently and significantly predicted the risk of prostatic adenocarcinoma. A suspicious nodule and obliterated median groove had PPV of 23.1% and lobar asymmetry, 0%. There was a statistically significant correlation (P = 0.005) between DRE findings and histology, between PSA and histology (P = 0.000) and between the size of the prostate and PSA value (P = 0.021). The mean size of the prostate was 101.2 g, standard deviation 92.11783, maximum 648 g and minimum 13.6 g. Conclusion: Most of the variants of abnormal DRE findings do not sufficiently predict the risk of adenocarcinoma on their own. They need to be in combination with other DRE findings or a raised PSA to significantly predict adenocarcinoma.

Urinary extracellular vesicles miRNA—A new era of prostate cancer biomarkers

“…PCa diagnosis currently relies on digital rectal examination (DRE) and blood PSA levels followed by a solid biopsy to confirm and characterize the malignancy. DRE sensitivity and specificity are reported to be 80% and 48.6% respectively which makes it dependent on validation via solid biopsy upon palpation and detection of irregularities in the prostate nodules (Irekpita et al, 2020). Although DRE provides significantly higher success rates in detecting high-grade PCa cases when compared to PSA levels, it still shows a limited overall predictive value and high invasiveness (Jones et al, 2018).…”

“…The following information was collected from the selected articles and tabulated in Tables 2, 3 (Roehrborn and Black, 2011). Authors' name, and publication year (Siegel et al, 2021); type of study design-case-control or cohort (Martin et al, 2018); sample size-number of benign, PCa, and healthy controls (Fenton et al, 2018); the volume of urine used for extraction and method of EV isolation (Irekpita et al, 2020); urine collection time point (pre-or post-DRE or DRE not considered) (Jones et al, 2018); method of miRNAs shortlisting for validation, type of RNA extraction (Balk et al, 2003); normalization of miRNA quantification (Stenman et al, 1999); differentially expressed miRNA reported (Gao et al, 2019); identified miRNA after validation, and (Hugosson et al, 2019) it is predictive value as compared to PSA (Tables 2, 3). Frontiers in Genetics frontiersin.org…”

Prostate Cancer Detection in Colombian Patients through E-Senses Devices in Exhaled Breath and Urine Samples

“…However, it is a technique with low reproducibility due to the variability between examiners who can interpret the results differently [13,14], since the presence of rectal touch abnormalities can include prostate enlargement, the appearance of suspicious nodules, lobular asymmetry, and hard consistency, among others; the above are not necessarily related to PCa, so they may be related to some other prostate disease. Another disadvantage presented by the DRE test is that the PCa in its early stage may not have the necessary size and rigidity to be palpable [15]. This test additionally causes considerable discomfort, is uncomfortable and embarrassing for patients, and is less accurate than the PSA test [16].…”

Effect of digital rectal examination on prostate specific antigen levels among patients with lower urinary tract symptoms in Uganda

“…For this reason, it has been recommended to perform PSA before DRE (14). Currently, both digital rectal examination and prostate speci c antigen done at the same time are recommended for prostate cancer screening because this technique offers up to 75% diagnostic sensitivity for prostate carcinoma (14,15). PSA testing, digital rectal exam (DRE), and prostate biopsy are the cornerstone of prostate cancer screening (15).…”

“…Currently, both digital rectal examination and prostate speci c antigen done at the same time are recommended for prostate cancer screening because this technique offers up to 75% diagnostic sensitivity for prostate carcinoma (14,15). PSA testing, digital rectal exam (DRE), and prostate biopsy are the cornerstone of prostate cancer screening (15). Most clients in our setting come to urology clinic as referrals from primary physicians when DRE has been done.…”