Digital rectal examination is not useful as a solitary screening tool for prostate cancer in young men

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Published: 16 Mar 2023
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Prof Peter Albers - Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

Prof Peter Albers speaks to ecancer about the results from the PROBASE trial. Digital rectal examination (DRE), in most guidelines, is a recommended screening tool for early prostate cancer detection.

PROBASE is a randomised screening trial that has accrued younger men to test a risk-adapted screening strategy using a baseline prostate specific antigen value with the additional offer of DRE in a large sub-cohort of participants.

Prof Albers says that the trial showed that DRE is not useful as a solitary screening tool for prostate cancer in young men. He says the results from Stockholm3 and PROBASE trials can prove beneficial in the field of prostate cancer screening.

I’m also leading a large screening trial in Germany with 50,000 participants aged 45. What we also published at this meeting is interim results of our control group where we performed digital rectal examination. As you might expect, in the screening setting we could prove that digital rectal examination is of limited value. From 6,500 men that we performed DRE, only three cancers were found that were insignificant. We had a control group with 660 biopsies with cancer and also in this group more than 80% had an unsuspicious DRE.

So DRE, obviously in the screening setting in young men, in our trial, is of no value and this might also influence the Stockholm3 test or the ESPC risk calculator for the younger age group because they have included DRE as one of the measurements. So by this… I only mention it because you can see there are a lot of things ongoing at the moment to more precisely detect men that need a biopsy, need invasive diagnostics and to lower down the group of men that don’t need biopsies.