How accurate is a digital rectal exam?

A digital rectal exam (DRE) is clearly not perfect at detecting prostate cancer. Most prostate tumors begin in the posterior portion of the gland near the wall of the rectum, so the tumors can be examined in a rectal exam. But if a tumor is located away from the rectal wall, the physician will not be able to palpate it during a DRE. As a result, a significant proportion of men with a normal DRE may still have prostate cancer. For example, in one study of 6,630 men volunteering for DRE and prostate-specific antigen screening tests, 45% of the cancers that were detected were missed by the DRE. Other authors have reported finding cancer in 15% to 18% of men with a normal DRE.

If a lump is found, the chances are about 1 in 4 that it is cancerous. The more obvious the abnormality, the more likely it is to be cancer. But most cancers associated with clearly abnormal DREs are already advanced because smaller tumors are more difficult to feel. DRE is less effective than PSA at finding prostate cancer, but there are instances when cancers are found by DRE in men who have normal PSA levels. For this reason, both the DRE and PSA tests are recommended for men who choose to undergo screening for prostate cancer.

The effectiveness of the exam is somewhat dependent on the experience of the examiner. A more experienced clinician can detect subtle abnormalities that a less experienced clinician may overlook. Although the DRE has been used for many years, whether it actually decreases the number of deaths from prostate cancer has not been determined.

Continue Learning about Prostate Cancer

What You Need to Know About Prostate Cancer
What You Need to Know About Prostate Cancer
Prostate cancer is the second most common cancer among men in the United States. In fact, the American Cancer Society predicts that nearly 181,000 men...
Read More
Is prostate cancer serious?
Dr. Robert E. Reiter, MDDr. Robert E. Reiter, MD
Prostate cancer is a very heterogeneous disease. It can range from extremely indolent and non-danger...
More Answers
What is stage 3 prostate cancer?
Sigma NursingSigma Nursing
Stage 3 prostate cancer has progressed to tissues near the prostate such as the seminal vesicles, bu...
More Answers
Are There Alternative Treatments for Prostate Cancer?
Are There Alternative Treatments for Prostate Cancer?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.