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Prostate cancer screening: a systematic review of digital rectal examinations in primary care settings

Canadian and UK researchers evaluate data from seven studies to review the diagnostic accuracy of digital rectal examinations

Canadian and UK researchers evaluate data from seven studies to review the diagnostic accuracy of digital rectal examinations

 


Picture: SPL

The digital rectal examination is used routinely and extensively in primary care to screen for prostate cancer. However, researchers from Canada and the UK suggest that the data underpinning its effectiveness is limited.

Their study, a systematic review and meta-analysis of the available evidence, examined data from seven studies, with a total of 9,241 enrolled patient participants.

Low quality of evidence

The researchers found that the quality of evidence was low, with all the studies used in the appraisal considered to be conceivably at risk of bias as certain factors – such as the criteria used to establish abnormal findings or how patients were enrolled – were not clear.

As such, the authors questioned the usefulness of this measure in terms of its exactness, consistency of findings and diagnostic accuracy and subsequently suggest that continuing to use the test might be associated with superfluous testing and significant harm, such as overdiagnosis and overtreatment.

However, they do acknowledge that their findings are, in turn, limited by various issues, such as the lack of a consistent definition for abnormal findings, information on who conducted the test or the setting in which the test was carried out.

Reference

Naji L et al (2018) Digital rectal examination for Prostate Cancer Screening in Primary Care: A systematic review and meta-analysis. Annals of Family Medicine. 16, 2, 149-154.


Dion Smyth is a lecturer-practitioner in cancer and palliative care, Birmingham City University

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