The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging
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...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-10-01
|
| Series: | Life |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-1729/14/11/1359 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850226831475605504 |
|---|---|
| author | Juan Morote Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró José M. Abascal Pol Servian Olga Méndez Enrique Trilla |
| author_facet | Juan Morote Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró José M. Abascal Pol Servian Olga Méndez Enrique Trilla |
| author_sort | Juan Morote |
| collection | DOAJ |
| description | 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 (<i>p</i> < 0.001), after fixing sensitivity at 90%. Prostate biopsy was avoided in 35.1 and 26.7%, respectively (<i>p</i> < 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. |
| format | Article |
| id | doaj-art-2845262cd8b44889bde09c0118cd8248 |
| institution | OA Journals |
| issn | 2075-1729 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj-art-2845262cd8b44889bde09c0118cd82482025-08-20T02:04:58ZengMDPI AGLife2075-17292024-10-011411135910.3390/life14111359The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance ImagingJuan Morote0Nahuel Paesano1Natàlia Picola2Jesús Muñoz-Rodriguez3Xavier Ruiz-Plazas4Marta V. Muñoz-Rivero5Ana Celma6Gemma García-de Manuel7Berta Miró8José M. Abascal9Pol Servian10Olga Méndez11Enrique Trilla12Department of Urology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Surgery, Universitat Autònoma de Barcelona, 08193 Bellaterra, SpainDepartment of Urology, Hospital Universitari de Bellvitge, 08907 Hospitalet de Llobregat, SpainDepartment of Urology, Hospital Universitari Parc Taulí, 08208 Sabadell, SpainDepartment of Urology, Hospital Universitari Joan XXIII, 43005 Tarragona, SpainDepartment of Urology, Hospital Univeritari Arnau de Vilanova, 25198 Lleida, SpainDepartment of Urology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Urology, Hospital Universitari Josep Trueta, 17007 Girona, SpainStatistics Unit, Vall d´Hebron Research Institute, 08035 Barcelona, SpainDepartment of Urology, Parc de Salut Mar, 08003 Barcelona, SpainDepartment of Urology, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, SpainUrology Research Unit, Vall d´Hebron Research Institute, 08035 Barcelona, SpainDepartment of Urology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainThe 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 (<i>p</i> < 0.001), after fixing sensitivity at 90%. Prostate biopsy was avoided in 35.1 and 26.7%, respectively (<i>p</i> < 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.https://www.mdpi.com/2075-1729/14/11/1359prostate cancerearly detectiondigital rectal examination |
| spellingShingle | Juan Morote Nahuel Paesano Natàlia Picola Jesús Muñoz-Rodriguez Xavier Ruiz-Plazas Marta V. Muñoz-Rivero Ana Celma Gemma García-de Manuel Berta Miró José M. Abascal Pol Servian Olga Méndez Enrique Trilla The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging Life prostate cancer early detection digital rectal examination |
| title | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
| title_full | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
| title_fullStr | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
| title_full_unstemmed | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
| title_short | The Role of Digital Rectal Examination for Early Detection of Significant Prostate Cancer in the Era of Magnetic Resonance Imaging |
| title_sort | role of digital rectal examination for early detection of significant prostate cancer in the era of magnetic resonance imaging |
| topic | prostate cancer early detection digital rectal examination |
| url | https://www.mdpi.com/2075-1729/14/11/1359 |
| work_keys_str_mv | AT juanmorote theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT nahuelpaesano theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT nataliapicola theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT jesusmunozrodriguez theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT xavierruizplazas theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT martavmunozrivero theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT anacelma theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT gemmagarciademanuel theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT bertamiro theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT josemabascal theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT polservian theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT olgamendez theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT enriquetrilla theroleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT juanmorote roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT nahuelpaesano roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT nataliapicola roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT jesusmunozrodriguez roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT xavierruizplazas roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT martavmunozrivero roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT anacelma roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT gemmagarciademanuel roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT bertamiro roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT josemabascal roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT polservian roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT olgamendez roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging AT enriquetrilla roleofdigitalrectalexaminationforearlydetectionofsignificantprostatecancerintheeraofmagneticresonanceimaging |