The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging
Morote Robles, Juan (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Paesano, Nahuel (Clínica Creu Blanca)
Picola, Natàlia (Hospital Universitari de Bellvitge)
Muñoz Rodríguez, José Manuel (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Ruiz-Plazas, Xavier (Hospital Universitari Joan XXIII de Tarragona)
Muñoz Rivero, Marta Viridiana (Hospital Universitari Arnau de Vilanova (Lleida))
Celma, Ana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
García-de Manuel, Gemma (Hospital Universitari de Girona Doctor Josep Trueta)
Miró, Berta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Abascal, Jose Maria (Parc de Salut MAR de Barcelona)
Servian, Pol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Méndez Fernández, Olga (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Trilla Herrera, Enrique (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Date:	2024
Abstract:	The role of digital rectal examination (DRE) in the early detection of significant prostate cancer (PCa) is being questioned in the era of magnetic resonance imaging (MRI). However, some men with suspected PCa may still be identified solely through DRE, even with low serum prostate-specific antigen (PSA) levels. Additionally, most predictive models designed to improve significant PCa diagnostic pathways incorporate DRE findings. We assessed the role of DRE among 5005 men with serum PSA levels > 3. 0 ng/mL and/or suspicious DRE findings, who underwent pre-biopsy MRI and targeted and/or systematic biopsies, as part of the significant PCa opportunistic screening program in Catalonia (Spain) between 2016 and 2023. Significant PCa, defined as grade group > 2, was detected in 2097 men (41. 9%). Suspicion of PCa was based solely on DRE in 206 cases (4. 1%) with significant PCa detected in 50 of them (2. 4%). Two pathways using the Barcelona predictive models, before and after MRI, with and without DRE findings showed specificities of 52. 8 and 38. 7%, respectively (p < 0. 001), after fixing sensitivity at 90%. Prostate biopsy was avoided in 35. 1 and 26. 7%, respectively (p < 0. 001), while its efficacy increased from 52. 8 to 58%. We conclude that DRE improved the effectiveness of an opportunistic significant PCa-screening program.
Grants:	Instituto de Salud Carlos III PI20/01666
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Prostate cancer ; Early detection ; Digital rectal examination
Published in:	Life, Vol. 14, Núm. 11 (October 2024) , ISSN 2075-1729

DOI: 10.3390/life14111359
PMID: 39598158

11 p, 834.4 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles