Do you know that approximately 39% of men and women are likely to be diagnosed with cancer at some point in their lifetime? This is an alarming figure, and it’s the main reason why early detection and diagnosis of cancer is vital for successful treatment. One of the screening tests performed for the early detection of prostate cancer is the digital rectal exam (DRE). This test involves a physical examination of the prostate gland through the rectum. However, there has been ongoing debate about the accuracy of the DRE in finding cancer. How accurate is a DRE at finding cancer? Let’s find out!
The Anatomy and Function of the Prostate Gland
The prostate gland is approximately the size of a walnut and is situated between the bladder and the penis. Its main function is to produce the fluid that nourishes and transports sperm. The prostate gland consists of three zones: the peripheral zone, central zone, and transitional zone. The peripheral zone is the most common site for prostate malignancy.
The Digital Rectal Exam Procedure
The digital rectal exam is a screening test for prostate cancer. It is usually performed by a healthcare provider during a routine physical examination. During the procedure, the healthcare provider gently inserts a gloved, lubricated finger into the rectum and feels the prostate gland for any irregularities or signs of cancer. The exam takes only a few minutes and is usually painless. However, some men may experience discomfort during the procedure.
The Accuracy of the Digital Rectal Exam in Detecting Prostate Cancer
According to the American Cancer Society, the digital rectal exam is not very accurate in detecting prostate cancer. The exam can only detect prostate cancers that are large enough to be felt through the rectal wall. Small and early-stage tumors are usually undetected through a DRE. In most cases, the DRE is used in combination with other screening tests such as the prostate-specific antigen (PSA) blood test or a transrectal ultrasound (TRUS).
The Prostate-Specific Antigen (PSA) Blood Test
The PSA blood test measures the level of PSA in the blood. PSA is produced by the prostate gland, and a higher than normal level of PSA in the blood may indicate the presence of prostate cancer. However, high PSA levels do not always mean that a man has prostate cancer. Prostatitis or benign prostatic hyperplasia (BPH) can also cause elevated PSA levels. Therefore, a prostate biopsy may be required to confirm the diagnosis of prostate cancer.
The Transrectal Ultrasound (TRUS) Test
The transrectal ultrasound is a screening test that uses sound waves to create images of the prostate gland. During the procedure, a small probe is inserted into the rectum, and sound waves are transmitted to the prostate gland. The images produced by the sound waves can help detect any abnormalities or signs of cancer in the prostate gland. The TRUS is usually used in combination with other screening tests such as the PSA blood test or a DRE.
The Importance of Regular Prostate Cancer Screening
Prostate cancer is a silent killer that often presents without any symptoms in its early stages. Therefore, regular prostate cancer screening is vital for the early detection and treatment of the disease. According to the American Cancer Society, men at average risk of prostate cancer should start getting screened for the disease at age 50. Men who are at higher risk of prostate cancer, such as those with a family history of the disease, should start getting screened at age 45.
The Pros and Cons of Digital Rectal Exam
Like any screening test, the digital rectal exam has its pros and cons. Let’s take a look at some of them:
The Pros of the Digital Rectal Exam
- The exam is non-invasive and painless.
- The exam can be performed during a routine physical examination.
- It is a low-cost screening test for prostate cancer.
The Cons of the Digital Rectal Exam
- The exam is not very accurate in detecting early-stage prostate cancer.
- Some men may find the exam uncomfortable or embarrassing.
- False-positive or false-negative results may occur.
The Bottom Line
The digital rectal exam is an important screening test for prostate cancer. However, it is not very accurate in detecting early-stage and small tumors. Therefore, it is usually used in combination with other screening tests such as the PSA blood test or a transrectal ultrasound. Regular prostate cancer screening is vital for the early detection and successful treatment of the disease. Men should discuss their risk factors for prostate cancer with their healthcare provider and determine the appropriate screening plan for them.
Frequently Asked Questions (FAQs)
Q: What is the accuracy of the digital rectal exam in detecting prostate cancer?
A: The digital rectal exam is not very accurate in detecting early-stage or small tumors. It can only detect prostate cancers that are large enough to be felt through the rectal wall. Therefore, it is usually used in combination with other screening tests such as the PSA blood test or a transrectal ultrasound.
Q: What is the prostate-specific antigen (PSA) blood test?
A: The PSA blood test measures the level of PSA in the blood. PSA is produced by the prostate gland, and a higher than normal level of PSA in the blood may indicate the presence of prostate cancer. However, high PSA levels do not always mean that a man has prostate cancer.
Q: What is a transrectal ultrasound (TRUS) test?
A: The transrectal ultrasound is a screening test that uses sound waves to create images of the prostate gland. During the procedure, a small probe is inserted into the rectum, and sound waves are transmitted to the prostate gland.
Q: What is the recommended age to start prostate cancer screening?
A: Men at average risk of prostate cancer should start getting screened for the disease at age 50. Men who are at higher risk of prostate cancer, such as those with a family history of the disease, should start getting screened at age 45.
Q: What are the risk factors for prostate cancer?
A: The risk factors for prostate cancer include age, family history of the disease, obesity, race, and exposure to certain chemicals or toxins.
References
- American Cancer Society. (2021). Can prostate cancer be found early? Retrieved from https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/detection.html
- National Cancer Institute. (2021). Prostate cancer screening (PDQ®)–Patient version. Retrieved from https://www.cancer.gov/types/prostate/patient/prostate-screening-pdq