Underutilization of Digital Rectal Examination When Screening for Prostate Cancer

Abstract

Digital rectal examination is underutilized when screening for prostate cancer. This leads to nondetection of some prostate cancers. Although the DRE rate was poor among all health care providers, female providers and physician extenders outperformed male providers and physicians, respectively.

How Adequate is Digital Rectal Exam for Prostate Cancer Screening at Colonoscopy? Can Adequacy be Improved?

“…A recent study found that DRE is underutilized when screening for prostate cancer, which can lead to nondetection of some prostate cancers [9].…”

Beyond the cultural myth of medical meritocracy

“…Women listen more and spend more time with patients . There are studies showing that women are better at making use of updated medical research findings, better at using diagnostic tools correctly and better at deciding when to operate on a patient . In addition, they work better in teams and manage complex problems more efficiently .…”

Missed digital rectal examination missed the primary diagnosis

“…However, there is good evidence to suggest that screening for prostate cancer increases its diagnosis at an early stage. The American Cancer Society and American Urology Association recommend screening with both digital rectal examination (DRE) and prostate-specific antigen (PSA) measurement [2]. DRE is the oldest and least invasive screening test for prostate cancer and serves as the initial diagnostic tool.…”

“…This is the part of the gland that is easily accessible on DRE. Although DRE can detect prostate cancers, it has less sensitivity, specificity and positive predictive value than PSA as a screening tool for prostate cancers [1][2][3]. Despite the limitations of DRE, it should not be abandoned because 20% of prostate cancers may be associated with normal serum PSA and may be detected by DRE [1].…”

“…A recent meta-analysis of PSA and DRE as screening tests for prostate carcinoma showed that when combined, they can detect 83.4% of prostate cancers in an early, localized stage [3]. Nevertheless DRE is underused by physicians when screening for prostate cancers [2]. This non-adherence to the guidelines can lead to failure to detect some prostate cancers, especially those with normal serum PSA levels.…”