Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men

The Journal of Urology
William J CatalonaPaula C Southwick

Abstract

To compare the efficacy of digital rectal examination and serum prostate specific antigen (PSA) in the early detection of prostate cancer, we conducted a prospective clinical trial at 6 university centers of 6,630 male volunteers 50 years old or older who underwent PSA determination (Hybritech Tandem-E or Tandem-R assays) and digital rectal examination. Quadrant biopsies were performed if the PSA level was greater than 4 micrograms/l or digital rectal examination was suspicious, even if transrectal ultrasonography revealed no areas suspicious for cancer. The results showed that 15% of the men had a PSA level of greater than 4 micrograms/l, 15% had a suspicious digital rectal examination and 26% had suspicious findings on either or both tests. Of 1,167 biopsies performed cancer was detected in 264. PSA detected significantly more tumors (82%, 216 of 264 cancers) than digital rectal examination (55%, 146 of 264, p = 0.001). The cancer detection rate was 3.2% for digital rectal examination, 4.6% for PSA and 5.8% for the 2 methods combined. Positive predictive value was 32% for PSA and 21% for digital rectal examination. Of 160 patients who underwent radical prostatectomy and pathological staging 114 (71%) had organ confined cancer...Continue Reading

References

Mar 1, 1992·The Journal of Urology·M K BrawerP H Lange
Mar 1, 1992·Human Pathology·P T ScardinoM A Hudson
Mar 1, 1992·The Journal of Urology·P C Walsh
Apr 25, 1991·The New England Journal of Medicine·W J CatalonaG L Andriole
Jan 1, 1991·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·A TurkesK Griffiths
Jan 1, 1992·Journal of Clinical Epidemiology·S S CoughlinM C Tefft
Jan 1, 1990·The Prostate·G D SteinbergP C Walsh
Mar 1, 1990·The Journal of Urology·W J Catalona, S W Bigg
Oct 8, 1987·The New England Journal of Medicine·T A StameyE Redwine
Aug 17, 1989·The New England Journal of Medicine·E D CrawfordP J Goodman

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Citations

Nov 1, 1994·The Journal of Urology·D S Smith, W J Catalona
May 1, 1995·British Journal of Urology·C DeliveliotisM A Dimopoulos
Oct 27, 1994·The New England Journal of Medicine·W J Catalona
Jan 15, 1997·Journal of the National Cancer Institute·R J HendersonO Sartor
Dec 11, 1995·International Journal of Cancer. Journal International Du Cancer·S A RabbaniA P Mazar
Jan 1, 1996·The Prostate. Supplement·R EtzioniM K Brawer
Jul 14, 2001·Critical Reviews in Clinical Laboratory Sciences·M J Duffy
Mar 16, 2001·Expert Opinion on Pharmacotherapy·D K Ornstein, R S Pruthi
Apr 28, 2001·Cancer Control : Journal of the Moffitt Cancer Center·M M Cookson
Oct 26, 2001·Scandinavian Journal of Urology and Nephrology·Y TakezawaH Yamanaka
Sep 10, 2002·The American Journal of Surgical Pathology·Rajal B ShahMark A Rubin
Oct 26, 2002·BMC Family Practice·Richard M HoffmanCharles R Key
Jan 15, 2004·Cancer Science·Kotaro OzasaUNKNOWN JACC Study Group
Oct 30, 2003·Cancer·Pankaj KalraCraig S Niederberger
May 19, 2004·International Journal of Urology : Official Journal of the Japanese Urological Association·Chaiyasit MatchariyakulPanuwat Lertsithichai
Sep 25, 2004·The Prostate·Ralf HerwigGeorg Bartsch
Sep 24, 2004·International Journal of Cancer. Journal International Du Cancer·Elga PezzatoSpiridione Garbisa
Jun 15, 2004·Prostate Cancer and Prostatic Diseases·D W Soderdahl, J Hernandez
Feb 12, 2005·BJU International·Naomi M GadesSteven J Jacobsen
Feb 15, 2005·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Carlos A L MartinezMiguel Srougi
Mar 29, 2006·Prostate Cancer and Prostatic Diseases·L Benecchi

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