Screening for prostate cancer at low PSA range: The impact of digital rectal examination on tumor incidence and tumor characteristics

Gosselaar, Claartje; Roobol, Monique J.; Roemeling, Stijn; Kwast, Theodorus H. van der; Schröder, Fritz H.

doi:10.1002/pros.20501

Cited by 43 publications

(32 citation statements)

References 33 publications

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“…We found no statistically significant differences between the two groups with regard to Gleason scores. However, Gosselaar et al 23 reported that DRE detected more selectively high-grade cancers. Furthermore, a population-based case-control study of screening and prostate cancer mortality in Olmsted County revealed that men who were screened by DRE were less likely to die from the disease than men who were not screened.…”

Section: Discussionmentioning

confidence: 99%

Digital rectal examination as a prostate cancer-screening method in a country with a low incidence of prostate cancer

Shim

Lee

Park

et al. 2007

Prostate Cancer Prostatic Dis

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The objective of this study was to evaluate the value of using digital rectal examination (DRE) for prostate cancer diagnosis in an Asian population. Patients with serum prostate-specific antigen (PSA) levels ranging from 2.5 to 19.9 ng/ml underwent transrectal ultrasonography-guided prostate biopsies. Patients were divided into two groups: the normal DRE group (n ¼ 721) and the abnormal DRE group (n ¼ 192). The cancer detection rate was higher in the abnormal DRE group (47.4%) than in the normal DRE group (23.0%) (Po0.001). However, the detection rates in these two groups were not significantly different in men 45-59 years old as well as in men with low PSA levels (2.5-3.9 ng/ ml). In all subjects, the areas under the receiver operating characteristic curves for positive biopsies were 60.0% (95% confidence interval (CI), 55.7-64.3%, Po0.001). However, in the subgroup analysis, the predictive power of the DRE was not significant in men 45-59 years old. In addition, DREs of patients with low PSA levels had no discriminative ability. The pathological features of the prostate biopsies were not significantly different between the two groups in subjects 45-59 years old and in subjects with PSA levels from 2.5 to 3.9 ng/ml. Our data indicate that DREs increase the probability of cancer detection. However, our findings also raise the question, 'Are DREs really useful for cancer detection in younger men and men with low PSA levels in the Asian population?'

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Section: Discussionmentioning

confidence: 99%

Digital rectal examination as a prostate cancer-screening method in a country with a low incidence of prostate cancer

Shim

Lee

Park

et al. 2007

Prostate Cancer Prostatic Dis

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“…Given the limited predictive value of an abnormal DRE or TRUS result in a screening setting, however, especially in the low tPSA range of approximately 3.0 g/L or 4.0 g/L, the actual decrease in PCa detection most likely will be closer to 19% or 20%, respectively, than to 9% or 11% (35)(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of New Prostate-Specific Antigen WHO Standardization on Biopsy Rates and Cancer Detection

Jansen¹,

Roobol²,

Bangma³

et al. 2008

Clinical Chemistry

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“…9 Dit geldt al helemaal voor de diagnostische waarde van het rectaal toucher en de transrectale echografie, waarbij de positief voorspellende waarde respectievelijk 9 en 11% was bij een PSA van >3,0 ng/ml. 10 Dit betekent dat een geobserveerde afwijking slechts bij ongeveer één op tien personen een carcinoom aan het licht bracht door middel van biopsie. Er dient derhalve een aanvullende methode gevonden te worden die nauwkeuriger aangeeft wie een detecteerbare vorm van kanker met zich meedraagt om daarmee de belasting van biopsieprocedures en kosten te verminderen.…”

Section: Technieken En Methodes Voor Prostaatscreeningunclassified

Bevolkingsonderzoek naar prostaatkanker

Bangma¹,

Roobol²

2009

BIJB

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1 Uroloog, Studiegroep ERSPC (www.erspc.org), afdeling Urologie, Erasmus MC Rotterdam 2 Epidemiologe, Studiegroep ERSPC (www.erspc.org), afdeling Urologie, Erasmus MC Rotterdam SamenvattingScreening met PSA (prostaatspecifiek antigeen) van de algemene populatie verlaagt de sterfte aan prostaatkanker met minimaal 20%. De European Randomised Study for Screening of Prostate Cancer (ERSPC) toont dit aan na gemiddeld negen jaar follow-up van ruim 162.000 mannen van 55 tot 69 jaar oud.* Om één sterftegeval aan prostaatkanker te kunnen voorkomen, moesten er 1410 mannen gescreend worden, waarbij een additionele 48 mannen in vergelijking met de controlepopulatie de diagnose prostaatkanker verkregen. Bij een overweging van de overheden of bevolkingsonderzoek geïndiceerd is, zullen ook andere elementen een rol spelen, zoals de kosteneffectiviteit en de kwaliteit van leven van de gewonnen jaren als gevolg van screening. Screening brengt overdiagnose van indolente tumoren en het risico van overbehandeling met zich mee. Voor de begeleiding van de individuele vraag naar vroege detectie staat een risico-indicator ter beschikking.

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Screening for prostate cancer at low PSA range: The impact of digital rectal examination on tumor incidence and tumor characteristics

Cited by 43 publications

References 33 publications

Digital rectal examination as a prostate cancer-screening method in a country with a low incidence of prostate cancer

Digital rectal examination as a prostate cancer-screening method in a country with a low incidence of prostate cancer

Clinical Impact of New Prostate-Specific Antigen WHO Standardization on Biopsy Rates and Cancer Detection

Bevolkingsonderzoek naar prostaatkanker

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