WINSTON-SALEM, N.C., Sept. 6 (UPI) -- Among the least favorite of all medical exams, the digital rectal exam for prostate cancer may be on the way out because other tests are more accurate in detecting the disease.
A large review of medical data found digital rectal exams gave false positives and often turned men off to any type of test for prostate cancer, according to researchers at Wake Forest University.
Digital rectal exams have long been a standard method for prostate cancer testing, despite an enlarged prostate not necessarily indicating cancer and the requirement for more testing if the prostate is enlarged.
The United States Protective Services Task Force in 2011 dropped its recommendation for routine prostate-specific antigen testing for all men over age 50 -- which has resulted in fewer diagnoses of prostate cancer, according to a study earlier this year -- but has not addressed recommendations for digital rectal exams.
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A study at Harvard University in June also showed PSA tests are the best method for detecting prostate cancer, despite the tests often showing false positives and requiring further confirmation of the threat of more deadly forms of the disease.
"Many practitioners continue to perform DRE in attempts to identify men with aggressive prostate cancer who could die from the disease," Dr. Ryan Terlecki, a urologist and researcher at Wake Forest Baptist Medical Center, said in a press release. "In the era of PSA testing, we wanted to explore whether it's time to abandon the digital exam."
For the study, published in the journal Current Medical Research and Opinion, researchers analyzed data on 38,340 men in the prostate, lung, colorectal and ovarian screening trial who received annual PSA and digital rectal examinations.
The researchers found found 2 percent of men with an abnormal digital rectal exam and normal PSA were diagnosed with clinically significant prostate cancer, compared 20 percent of men who received abnormal results of both tests.
The researchers say capturing an additional 2 percent of men with significant prostate cancer may not be worth exposing so many men to an uncomfortable exam most do not want, but say it should be left up to doctors and patients themselves.
"The evidence suggests that in most cases, it is time to abandon the digital rectal exam," Terlecki said. "Our findings will likely be welcomed by patients and doctors alike."
