Newswire (Published: Tuesday, July 4, 2017, 3:31:00 PM CDT, Received: Tuesday, July 4, 2017, 3:42:13 PM CDT)

Word Count: 339

Digital rectal examination is up to 68% accurate in early diagnosis of men without symptoms

LESS than one in seven doctors examines the prostate gland for cancer, with excuses including “My finger is too short”.

Other reasons given for not performing a digital rectal examination include: “It might be taken as sexual harassment”, “There’s no privacy in the ward” and “There’s no lubricant”.

Kalli Spencer, a urologist at the Wits University Medical School, questioned 303 doctors — excluding urologists — to find out whether they tested for prostate cancer and, if not, why not.

Writing in the SA Medical Journal, Spencer said digital exams were uncommon “which might have significant clinical implications”.

Prostate cancer is the most common solid-organ cancer among men, according to the SA National Cancer Registry. Blacks are at highest risk.

Said Spencer: “The incidence increases at about 3% a year, with one in 26 men developing prostate cancer and five men dying because of it every day.”

Screening with an examination and a prostate-specific antigen blood test are important for early detection but doctors at the Charlotte Maxeke, Helen Joseph and Chris Hani-Baragwanath academic hospitals are not keen on feeling the prostate through a man’s rectum.

One said: “It is an intrusive waste of time carrying out rectal examinations.”

But Spencer said 18% of cancer cases were detected by a doctor’s finger. Digital rectal examination, or DRE, is up to 68% accurate in the early diagnosis of men without symptoms of cancer.

“General practitioners or other non-urologists should always perform DREs as part of their examination for the early detection of cancer,” he said.

Four of the reasons doctors gave for not doing examinations were more prevalent among women: no privacy, cultural or religious convictions, anticipated patient refusal and concern about the patient’s modesty.

Said Spencer: “The under-performance of DREs not only leads to non-detection of some prostate cancers but also deprives junior doctors of training.

“Teaching medical students physical examination techniques on real patients is an important part of medical education.”


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