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Observational screening study reveals low predictive value of digital rectal examination in men aged 40 to 70 years, indicating the necessity of adjunctive diagnostic tools.
The results of routine urological screening of 2,005 men between 40 and 70 years old were reviewed. Digital rectal examination was used to screen for adenocarcinoma of the prostate. Of 65 nodules detected 17 proved to be adenocarcinoma. Clinical staging revealed no evidence of metastases in all but 2 patients but pathological (surgical) examination resulted in upstaging of disease in 66 per cent of the patients who underwent an operation. Digital rectal examination proved to be an insensitive screening device with poor predictive value. The use of adjunctive screening tools for detection of adenocarcinoma of the prostate is suggested.
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Thompson et al. (1984) studied this question.
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