An analysis of digital rectal examination and serum-prostate-specific antigen in the early detection of prostate cancer in general practice

Abstract

Background: Prostate cancer is now the commonest cancer in men and the second commonest cause of death from cancer. However, general-practice-based research on prostate cancer remains scanty.

Objectives: We aimed to examine the acceptability of digital rectal examination (DRE) and serum-prostate-specific antigen (PSA) in the early detection of prostate cancer in a general practice setting. Another aim was to ascertain the incidence of prostate cancer among 50-79-year-old men in the solo practice.

Methods: We conducted an opportunistic, prospective, population-based study involving men with no prior, proven history of prostate cancer.

Results: A total of 211 (87.6%) out of 241 targeted patients agreed to take part in the study. Abnormal DREs were found in 9%, while 9.5% of PSA tests were found to be abnormal. One or both tests were abnormal in 29 patients-13.7% of the study population. Eleven biopsies were performed during the study, with cancer detected in three (27.3%)-1.4% of the total population. Eighteen patients were not biopsied either on clinical grounds or by personal choice.

Conclusions: The incidence of abnormal DRE and PSA tests was lower than that detected in previous hospital or specialist-based studies. Both tests were found to be highly acceptable to the population studied. Not all patients with abnormal early detection tests need necessarily proceed to further invasive investigations.