Clinical diagnosis of prostate cancer using digital rectal examination and prostate-specific antigen tests: a systematic review and meta-analysis of sensitivity and specificity

Abstract

Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.

Occurrence and significance of fluoroquinolone-resistant and ESBL-producing Escherichia coli and Klebsiella pneumoniae complex of the rectal flora in Ghanaian patients undergoing prostate biopsy

“…We conducted a prospective cohort study involving patients presenting for TRUS-B either because of an increased age-corrected prostate-specific antigen (PSA) level and/or abnormal digital rectal examination findings—including a nodule, induration or asymmetry—that might indicate prostate cancer. 30–32 Our primary aim was to report on the rectal carriage of FQ-resistant and ESBL-producing enterobacteria, the occurrence of post-TRUS-B infections, and the current antibiotic prophylactic strategy. The secondary aims were risk factors for rectal carriage and factors that may contribute to the predisposition of the patients to post-biopsy infection.…”

Liquid biopsies: the future of cancer early detection

“…Another study identified that up to 42% of men diagnosed with prostate cancer are individuals that would never have developed clinical symptoms in their lifetime [ 83 ]. High levels of false positive results can expose patients to unnecessary follow up appointments and procedures [ 84 ].…”

The Relationship Between Histopathology and Physiology in The Diagnosis of Diseases

“…PSA testing, along with digital rectal examination, can help identify prostate cancer at an early stage, enabling timely treatment and potentially enhancing the outlook for patients [60]. Additional Aca.…”