Digital Rectal Examination (DRE). The evidence for performing a DRE for screening for either rectal or prostate cancer was deemed to be insufficient by Oboler and LaForce (
table 2). No studies have assessed the benefits and harms of the DRE for
colorectal cancer (CRC) screening and no major organization (VA, USPSTF, American College of Physicians, American Cancer Society) recommends it. The 2008 USPSTF recommendations evaluated several procedures for CRC screening. The DRE was not considered as an option.
Currently, the majority of
prostate cancers are found by screening with the prostate specific antigen (PSA) test, which has been given an “insufficient evidence” rating by the USPSTF for men younger than 75 years of age and a recommendation against screening for men age 75 years and older. No screening or treatment trials have adequately assessed the benefits and harms of the DRE for prostate cancer screening in the absence of other procedures (i.e. PSA testing). Moreover, no screening trials, most of which relied primarily on PSA testing, have shown a reduction in prostate cancer or overall mortality. One randomized screening trial in the US specifically included annual DRE with PSA testing. Among men assigned to 6 annual rounds of PSA screening that included 4 rounds of DRE there was no reduction in prostate cancer mortality through 10 years of follow-up compared to men assigned to usual care (
Andriole 2009).