Digital rectal examination (DRE)
DRE involves manual examination of the prostate gland through the rectum to check any abnormality in size, shape or texture. If a man requests PSA test after being fully counselled on the benefits and risks, DRE should also be performed.
The combination of DRE and PSA testing has been shown to improve prostate cancer detection rates compared with either test used alone.1,2
DRE tests have a low specificity and sensitivity
It is not possible to feel the entire prostate or any small tumours present.
Around 25–35% of the prostate is inaccessible by DRE and cancers in this area may be missed.3
For more information
- Catalona WJ, Richie JP, Ahmann FR, et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol 1994;151:1283–90.
- Carroll P, Coley C, McLeod D, et al. Prostate-specific antigen best practice policy--part I: early detection and diagnosis of prostate cancer. Urology 2001;57:217–24.
- U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services 2012 2012. www.ahrq.gov/clinic/pocketgd1011/pocketgd1011.pdf (accessed 12 January 2013).