How effective is a digital rectal examination in prostate cancer screening?

Dr. Marc B. Garnick, MD
Hematologist & Oncologist

A digital rectal examination (DRE) is a screening test in which the physician inserts a gloved finger into the rectum to feel the prostate for abnormalities. It is a useful screening test, but it isn't foolproof. Its accuracy depends on the skill of the physician doing the test. Moreover, early cancerous tumors are often too small to detect during a DRE, and some are located in areas a doctor's finger can't reach. (Only the back of the gland can be felt, but this is where most prostate cancers develop.) For these reasons, clinicians who use DRE alone to screen for prostate cancer sometimes miss the smallest and most treatable tumors. That's why many physicians also perform a prostate-specific antigen test. On the other hand, small tumors that can't be felt by the physician may be less likely to cause future problems.

A digital rectal exam is an examination done by a health professional by inserting a lubricated, gloved finger into the patient's rectum to examine the prostate for any abnormalities or growths. It's called a 'digital" rectal exam because you use your finger which is a digit, not an electronic piece of equipment. This test can be used to as part of screening for cancer in the prostate, as well as the rectum or colon.

Dr. Mark S. Litwin, MD

The word digital in the digital rectal examination (DRE) for prostate cancer has nothing to do with a computer. Digital refers to the doctor's finger, or digit, that is placed into the rectum and onto the prostate during the exam. It can be a little embarrassing and slightly uncomfortable, but this exam can be a lifesaver if it leads to the early diagnosis of prostate cancer.

Many times, a man can harbor prostate cancer even though the digital rectal exam (DRE) result is completely normal. In those cases, the tumor can be deep inside the gland, not close to the edge of the prostate, and therefore the doctor may not be able to feel an abnormality. Alternatively, the tumor might be far away from the wall of the prostate or simply too small to be palpated. You certainly want to have a normal prostate exam, but it doesn't get you off the hook completely. A prostate-specific antigen (PSA) blood test is therefore also necessary for early detection.

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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.