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.