Digital rectal examination in prostate cancer screening at PSA level 3.0-3.9 ng/ml : long-term results from a randomized trial

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http://hdl.handle.net/10138/340437

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Soronen , V , Talala , K , Raitanen , J , Taari , K , Tammela , T & Auvinen , A 2021 , ' Digital rectal examination in prostate cancer screening at PSA level 3.0-3.9 ng/ml : long-term results from a randomized trial ' , Scandinavian Journal of Urology , vol. 55 , no. 5 , pp. 348-353 . https://doi.org/10.1080/21681805.2021.1966095

Title: Digital rectal examination in prostate cancer screening at PSA level 3.0-3.9 ng/ml : long-term results from a randomized trial
Author: Soronen, Veera; Talala, Kirsi; Raitanen, Jani; Taari, Kimmo; Tammela, Teuvo; Auvinen, Anssi
Contributor organization: HUS Abdominal Center
Clinicum
Urologian yksikkö
Department of Surgery
Date: 2021-09-03
Language: eng
Number of pages: 6
Belongs to series: Scandinavian Journal of Urology
ISSN: 2168-1805
DOI: https://doi.org/10.1080/21681805.2021.1966095
URI: http://hdl.handle.net/10138/340437
Abstract: Objective To evaluate digital rectal examination (DRE) as a predictor of prostate cancer (PC) at serum PSA level 3.0-3.9 ng/ml. We compared the PC incidence rates of men with different screening test results in this PSA range and analyzed DRE in comparison with free/total PSA ratio as an additional screening test. Materials and methods Using data from the FinRSPC trial, PC incidence rate ratios (IRR) for groups defined by the secondary screening test results (DRE vs. free/total PSA) were calculated for 17-year follow-up, using adjustment for age, family history of PC and place of residence. Screening test performance was evaluated by calculating sensitivity, specificity, positive and negative predictive value, and likelihood ratio. Results The IRR for men with a positive DRE compared to those with a negative result was 1.40 (95% confidence interval (CI) 1.00-1.96), while the IRR for men with a positive free/total PSA result compared to those with a negative one was 1.62 (95% CI 1.08-2.43). The estimated sensitivity was 0.15 (95% CI 0.11-0.20, 40/270) for DRE and 0.32 (95% CI 0.23-0.41, 36/113) for free/total PSA, and the specificity 0.91 (95% CI 0.88-0.93, 419/461) for DRE and 0.85 (95% CI 0.78-0.90, 134/158) for free/total PSA. Conclusions Our results do not support utility of DRE as a screening test for PC at serum PSA level 3.0-3.9 ng/ml, while the results regarding free/total PSA determination were more encouraging and reconfirm the decision to switch from DRE to free/total PSA.
Subject: Prostate neoplasms
screening
incidence
Finland
epidemiology
ANTIGEN
MORTALITY
DIAGNOSIS
SERUM
ALPHA-1-ANTICHYMOTRYPSIN
COMPLEX
ERSPC
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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