Psa Test Vs Digital Exam

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Men: Cancer Screening Exams By Age

PSA blood test and Digital Rectal Examination (DRE) – Outcomes

These exams are for men at average risk of cancer.

Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.

These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.

Ages 40-49

  • Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
  • If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.

Ages 50-75

Age 76 and older

If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.

All Ages

Speak with you doctor about cancer screening exams for lung and skin cancers. Exams are available for those at increased risk.

Regardless of your age, practice awareness. This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.

Why Do I Need Both A Digital Rectal Exam And A Psa Test

Dr. Kevin Kelly answers the question: ‘Digital Rectal Exam, PSA Test Or Both?’

March 16, 2009 — Question: Why do I need both a digital rectal exam and a PSA test?

Answer: Unfortunately, a digital rectal exam, they only palpate around 10 percent of the prostate gland itself. So by itself it is not very accurate to diagnose prostate cancer. Unfortunately PSA does not detect all prostate tumors. Additional tumors can be detected by a digital rectal exam, so most studies shows that most benefit of detection and screening of prostate cancer, if you use a combination of the prostate specific antigen plus a digital rectal exam.

What To Expect During Your Digital Rectal Exam

I typically use a mannequin to show my patients the area Ill examine during their DRE. The prostate is a walnut-sized organ that sits right in front of the rectum, directly under the bladder. We cant feel the prostate from outside the body, so the rectum is our best and easiest way to access it.

During the exam, your doctor will wear a glove. Theyll lubricate their finger so the test is a little more comfortable. Youll be undressed below the waist, either bending over the exam table or lying on the table on your side. The doctor will insert a finger and feel for any lumps or hardened areas on the prostate. The test takes just a few seconds to complete. You may feel like you have to urinate during the test, and there may be some discomfort. However, it usually isnt painful.

Though a digital rectal exam may be a little awkward, it plays an important part in the early diagnosis of prostate disorders and cancer. Ask your doctor about your risk for prostate cancer and whether you need to schedule this quick, potentially lifesaving procedure.

Call or click below to make an appointment for a prostate cancer screening.

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What Is The Psa Test

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.

The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.

PSA testing is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem.

In addition to prostate cancer, several benign conditions can cause a persons PSA level to rise, particularly prostatitis and benign prostatic hyperplasia . There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.

Repeating The Psa Test


A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.

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What Does Prostate Cancer Screening Entail

There are two types of prostate cancer screening exams and both should be done in conjunction with the other: A digital rectal exam and a prostate-specific antigen blood test .

A DRE is a physical exam in which the physician lubricates a gloved finger to gently examine the patients rectum. If it is enlarged or irregular in shape, the doctor will be able to easily detect it. While it may be uncomfortable, the test brief and can be life-saving.

A PSA test is a blood test that measures the level of prostate-specific antigens in the blood. Rising levels of PSA can be one of the first signs of prostate cancer, allowing for early detection and treatment.

Digital Rectal Exam Vs Psa Test For Prostate Cancer

Published: 2016-09-27 – Updated: 2020-04-30Author: Dr. David Samadi Prostate Cancer Center | Contact: ProstateCancer911.comPeer-Reviewed Publication: N/AJump to:Main Digest | Publications

Synopsis:Is the digital rectal exam as a screening tool for prostate cancer as good as the prostate specific antigen test. One of the more unpleasant and invasive screening tests men have to endure in checking for prostate cancer is the digital rectal exam . This analysis confirms those findings indicating that as an independent screening tool, PSA is superior to DRE.

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I Have High Psa Levels: How Do I Find Out If I Have Prostate Cancer

A digital rectal exam is usually done at the same time that your doctor orders a PSA test. For a digital rectal exam, your doctor will insert a lubricated, gloved finger into your rectum to feel your prostate. By pressing on your prostate, your doctor may be able to detect any lumps or hard areas that might indicate the presence of cancer.

How Is Prostate Cancer Detected

Prostate Cancer Symptoms And The PSA Blood Test – Macmillan Cancer Support

There is no single test to detect prostate cancer. The two most common tests are the prostate specific antigen blood test and the digital rectal examination .

The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.

A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.

If either of these tests suggest an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging scan and transrectal ultrasound biopsy.

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If You Do Choose Screening Should You Have A Rectal Examination

Doctors have a hackneyed saying about rectal examinations: if you dont put your finger in it, youll put your foot in it.

The point is that we can miss important things by not doing a rectal examination. This can be true for some people with symptoms, such as rectal bleeding. But on balance, it seems its not the case for prostate cancer screening.

We need to decide where to set the threshold for what is considered normal for diagnostic tests. This is the case for the PSA blood test, where traditionally we use a cut-off of four nanograms per millilitre as dividing normal from abnormal .

Set the cut-off too low, close to zero, and well send nearly all men for biopsies that are largely unnecessary. Set the cut-off too high and well miss many prostate cancers. Unfortunately, theres no magic threshold that perfectly divides the men with the cancers we want to catch from the men we neednt trouble.

Does the digital rectal examination improve matters when added to the PSA test? Not really. The rectal examination does pick up slightly more cancers, but these seem to be mostly the less aggressive cancers, less likely to be the ones we need worry about. In doing so, it causes more false alarms, by creating two or more false positive results for every cancer found.

Why would we want to perform an examination that many men find unpleasant when we could instead simply interpret the blood test a little differently?

Early Detection Saves Lives

Prostate cancer is the most common cancer affecting Australian men .

Prostate cancer is the growth of abnormal cells in the prostate gland. This gland is only found in males and is about the size of a walnut.

The causes of prostate cancer are not understood and there is currently no clear prevention strategy.

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What Does A Dre Involve

You might have a DRE at your GP surgery or at the hospital.

The doctor or nurse will ask you to lie on your side on an examination table, with your knees brought up towards your chest. They will slide a finger gently into your back passage. Theyll wear gloves and put some gel on their finger to make it more comfortable.

You may find the DRE slightly uncomfortable or embarrassing, but the test isnt usually painful and it doesnt take long.

What Is Prostate Cancer Screening

Characteristics of Prostate Cancer Detected by Digital Rectal ...

The prostate is a gland at the base of the male bladder which wraps itself around the beginning of the urethra . Though small, it can cause big problems for mens well-being. Prostate cancer is the fourth leading cause of death in Australian men, after heart attacks, lung cancer and stroke.

The hope with cancer screening is that, by picking up cancer early, we may forestall death and avoid suffering. But for prostate cancer, our screening tests have significant limitations.

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Should You Choose To Be Screened For Prostate Cancer At All

Prostate cancer is a disease that many men die with rather than of that is, despite aggressive prostate cancer killing some men, many more men would peacefully co-exist with their mild prostate cancers if they were left undiscovered.

Detecting prostate cancer might do good if it allows timely treatment to save mens lives, but can do harm via treatment side-effects: impotence, incontinence, the anxiety of false alarms or of discovering cancer, and so on.

Whether prostate screening saves lives at all is still debated. Several trials have found no preventive effect. The best-conducted trial showed that screening could prevent about one in five deaths from prostate cancer. However, this protection doesnt happen very often.

For a useful illustration, see the second page of this information sheet. This shows that over 11 years, about 1,000 men must be screened to save one life. In saving this one life, the trade-offs include:

  • scores of men will have to undergo a prostate biopsy
  • several will have complications of this biopsy
  • about 37 extra men will find out they have prostate cancer
  • several will suffer cancer treatment side effects such as impotence or incontinence.

How should we weigh up these pros and cons?

For some men, the small chance of benefit and the larger risk of harm leads them to decide not to proceed with testing. For others, the possibility of averting a cancer death, though small and uncertain, is worth the risks.

Screening Tests For Prostate Cancer

Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.

The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.

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Alternatives To The Psa Screening Test

Men cant afford to be in the dark about the state of their prostate. Its estimated that the average American man has a one in nine chance of having prostate cancer during their lifetime. Thats more common than either lung or colon cancer. Luckily, a screening developed about 30 years ago called the prostate-specific antigen test can help detect cancer earlier and better than the old-school-finger-exam of the prostate. In fact, blood PSA testing is estimated to save the lives of thousands of men every year.

But alas, there are two edges to every sword. While an elevated PSA can mean that cancer is present, it doesnt always mean that cancer is present. Thats because PSA levels are influenced by conditions other than cancer, such as normal, age-related prostatic enlargement as well as inflammation. Even are suspect when it comes to PSA elevation. Furthermore, some herbals, daily aspirin, being overweight, taking finasteride , and some cholesterol and blood pressure medications can lower PSA levels, further complicating its ability to detect cancer. So, PSA isnt really a reliable marker for making the diagnosis of prostate cancer but is much better for following cancer after it is diagnosed. In other words, PSA is more of the prostates weatherman of whats happening on all fronts than it is an accurate cancer marker.

Heres a list of several more sophisticated, biomarker tests that have gained popularity over the last several years:

The Pros And Cons Of Psa Screening

10 Warning Signs of Prostate Cancer

Whether you are considering medication for BPH or erectile dysfunction, or debating between radiation therapy and surgery for prostate cancer, you need to review your options carefully. This report, which provides an objective assessment of the risks and benefits of various procedures, can help. More than a primer on the most common prostate conditions, this unique publication includes roundtable discussions with experts at the forefront of prostate cancer research.

A prostate-specific antigen blood test measures the level of a protein called prostate-specific antigen , which is made by cells in the prostate. Doctors use the test to detect prostate cancer. Since its introduction in the late 1980s, the prostate-specific antigen test has been hailed as a way to detect prostate cancer in its earliest, most curable stage. It has been called one of the most important tests a man can have. So why are many experts now stepping back, and even discouraging the use of widespread PSA screening?

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Digital Rectal Exam Remains Important Part Of Prostate Screening Study Shows

HERSHEY, Pa. — The digital rectal exam is an important screening test that can discover prostate cancer that a prostate-specific antigen or PSA test may not, despite the higher sensitivity of the PSA test, according to Penn State College of Medicine researchers.

The digital rectal examination is a procedure where a physician feels the surface of the prostate with a gloved finger. The doctor is able to feel any lumps or hard areas on the prostate.

A PSA test checks for levels of prostate-specific antigen in the blood, with higher levels signaling potential cancer. As men age, the acceptable PSA level increases.

“Prostate cancer is the most common cancer in men, accounting for over 28,000 deaths yearly,” said Jay Raman, associate professor of surgery. “Improvements in screening methodology and refinements in cancer care have contributed, in part, to a reduction in recent mortality rates.”

An elevated PSA level or an abnormality found on the prostate during the digital rectal exam typically leads to the recommendation of prostate needle biopsy, the most accurate diagnostic technique. Elevated PSA levels have been shown to more accurately predict a positive cancer biopsy result than the rectal exam. The digital rectal exam has been considered less precise because there is variability regarding who administers the test and the experience of that person, and incorrect positives associated with noncancerous abnormalities.

Prostate Exam Vs Colonoscopy: Whats The Difference

At first glance, it might seem that a prostate exam is similar to a colonoscopy. After all, both exams involve your rectal area. However, these two tests are quite different.

While a prostate exam involves feeling the prostate with a gloved finger, a colonoscopy examines the walls of your colon by inserting a flexible camera into your rectum. The prostate is not examined at all during this procedure unless your healthcare provider manually performs an exam.

A prostate exam is a fairly quick procedure performed in an office setting. A colonoscopy, on the other hand, is an outpatient procedure in the hospital that requires IV sedation.

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