Prostate Cancer Screening: Is the Digital Rectal Exam Necessary?
Prostate cancer is a common concern for men, particularly as they age. It’s estimated that 1 in 8 men will be diagnosed with prostate cancer in their lifetime, making it the second most common cancer in men. Screening for prostate cancer typically involves a combination of a digital rectal exam (DRE) and a prostate-specific antigen (PSA) blood test. However, the use of DRE in prostate cancer surveillance has been controversial.
As a clinician focused on testosterone replacement, I always look for the latest information and research to improve patient care. I recently read an interesting Medscape article titled “Omit Digital Rectal Exam in Prostate Cancer Surveillance?” by Jake Remaly, and I wanted to share some key takeaways and how they relate to our clinic’s approach to prostate cancer screening.
The article on Medscape highlights a recent study published in the Journal of Urology that found omitting the digital rectal exam in prostate cancer surveillance did not lead to an increase in advanced disease or prostate cancer-specific mortality. The study included over 1,000 men who were diagnosed with low-risk prostate cancer and were followed for an average of 7 years. The researchers found that omitting the DRE did not significantly impact the outcomes of these patients.
(The study can be found here.)
What This Means for Our Patients
It’s imperative to note that this study focused on men with low-risk prostate cancer, so it’s not necessarily applicable to all patients. However, it does suggest that the use of DRE in prostate cancer surveillance may not be necessary in all cases.
Prostate cancer screening and surveillance may include PSA testing, DRE, and imaging studies such as a prostate MRI. In our practice, a referral to urology is deemed an absolute need if cancer is suspected—we consider a patient’s risk factors and preferences when determining the best course of action.
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It’s essential for men to be proactive about their prostate health and to have open and honest conversations with their healthcare providers. If you have any concerns or questions about prostate cancer screening, don’t hesitate to bring them up with your provider.
Recent research suggests that omitting the digital rectal exam in prostate cancer surveillance may not significantly impact outcomes in men with low-risk prostate cancer. However, it’s important to take a personalized approach to prostate cancer screening and surveillance in cooperation with your healthcare provider.
At our clinics, we strive to provide the highest quality of care and to stay up-to-date with the latest research and best practices in prostate health. If you have questions about symptoms of Low T or how your personal and family history of prostate issues may impact your candidacy for Testosterone Replacement Therapy (TRT), please contact us for a free consultation!
