Digital rectal examination, the method used to examine the prostate with a finger for swelling or unusual lumps in the rectum as an initial measure to detect signs of prostate cancer in men, may no longer be used in the not too distant future. . The study was carried out by scientists thanks to their PROBASE trial, coordinated by the German Center for Cancer Research (Deutsches Krebsforschungszentrum, DKFZ) of Heidelbergand was presented at the Annual Congress of the European Association of Urology in Milan.
According to this study, the technique could be bypassing many cancers in their initial phasesTherefore, the researchers call for other routine screening methods to be used.
«One of the main reasons for prostate cancer screening is to detect it as soon as possible, since this way better treatment results are obtained”, says Agne Krilaviciute, lead author of the study. “But our study suggests it’s not sensitive enough to detect those early-stage cancers.”
Essay TRY IT is a German multicenter study of prostate cancer screening across four university centers and involves 46,495 45-year-old men who enrolled between 2014 and 2019. Since then, the men have been followed up to assess their health over the years. after screening. Half of the trial participants were offered blood work tests immediately at age 45, while the other half were initially offered digital rectal examination with delayed prostate-specific antigen (PSA) screening at age 50. .
Compared to the detection rate using other methods, such as psa Test, the DRE detection rate was substantially lower, Krilaviciute says.
«The rectal tattoo gave a negative result in 99% of cases, and even those that were considered suspicious had a low detection rate,” says Krilaviciute. “The results we have seen in the PROBASE trial show that PSA test at age 45 he detected four times more prostate cancers.
Researchers believe that one reason DREs may be failing to detect cancers, especially in younger men, is because changes in prostate tissue may be too slight to detect with a finger. . Also, some cancers occur in a part of the prostate that cannot be easily reached with a finger.
“Early stage cancer may not have the necessary size and stiffness to be palpable,” explains Peter Albers, a urologist at the University of Düsseldorf and lead author of the study.
Some cancers occur in a part of the prostate that cannot be easily reached with a finger
“A separate analysis using MRIs before biopsies to locate prostate cancers showed that about 80% of these are in an area that should be easy to reach with a finger, and yet cancers were not detectable by digital rectal examination».
The researchers are now calling for the widespread use of PSA tests and MRIs as part of screening programs instead of DREs.