title: Comparison of digital rectal examination and prostate specific antigen in early detection of prostate cancer.
abstract: This study compares the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer. 1,000 men aged > or = 50 from the Osijek surroundings were examined. The subjects with prostatitis were excluded from the study. The subjects with elevated concentration of total prostate specific antigen and/or digital rectal examination suspect of carcinoma underwent prostate biopsy. The rate of prostate cancer detection showed to be 3.3% for PSA > 4 ng/ml, 2% for abnormal finding of DRE, and 3.7% for combination of the two methods. Out of 35 patients with prostate cancer detected, 19 had suspect DRE finding and 32 had PSA exceeding 4 ng/ml. Thus, PSA pointed to the diagnosis of prostate cancer in 91.4%, and abnormal finding of DRE in 54.2% of cases, the difference being statistically significant. The positive predictive value was 48.7% for abnormal finding of DRE, 47% for PSA > 4 ng/ml, and 80.0% for the combination of both. Although PSA determination detected a considerable proportion of tumors missed on DRE, the former alone was found to be insufficient as a screening method because of its inadequate sensitivity. When combined with digital rectal examination, the probability of prostate cancer detection increased considerably.
authors.affiliation: University Department of Urology, University Hospital Osijek, Osijek, Croatia.
authors.forename: Josip
authors.initials: J
authors.lastname: Galić
authors.forename: Ivan
authors.initials: I
authors.lastname: Karner
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Cenan
authors.forename: Antun
authors.initials: A
authors.lastname: Tucak
authors.forename: Ivana
authors.initials: I
authors.lastname: Hegedus
authors.forename: Josko
authors.initials: J
authors.lastname: Pasini
authors.forename: Marijana
authors.initials: M
authors.lastname: Bilandzija-Peranović
authors.forename: Slobodan
authors.initials: S
authors.lastname: Mihaljević
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen