Predictive value of digital rectal examination for prostate cancer detection is modified by obesity.

Journal Article (Journal Article)

The American Cancer Society's updated screening guidelines for prostate cancer (CaP) render digital rectal examination (DRE) optional. We investigated the impact of DRE on CaP detection among obese men. Data from 2794 men undergoing initial prostate biopsy at three centers were analyzed to assess CaP risk attributed to abnormal DRE across body mass index (BMI) categories. Predictive accuracies of a combination of PSA, age, race, center and biopsy year including or excluding DRE findings were compared by areas under the receiver-operating characteristics curves. In all cohorts, obese men were less likely to have abnormal DREs diagnosed than non-obese men. As BMI category increased, abnormal DREs became stronger predictors for overall CaP in individual (P-trends ≤ 0.05) and combined (P-trend<0.001) cohorts, and for high-grade CaP in the Italian (P-trend=0.03) and combined (P-trend=0.03) cohorts. DRE inclusion improved the predictive accuracy for overall and high-grade CaP detection among all obese men (P ≤ 0.032) but not normal-weight men (P ≥ 0.198). DRE inclusion also near-significantly improved overall CaP detection in obese men with PSA<4 ng ml(-1) (P=0.081). In conclusion, the predictive value of DRE is dependent on obesity and is significantly higher among obese men than normal-weight men.

Full Text

Duke Authors

Cited Authors

  • Chu, DI; De Nunzio, C; Gerber, L; Thomas, J-A; Calloway, EE; Albisinni, S; Senocak, C; McKeever, MG; Moreira, DM; Tubaro, A; Moul, JW; Freedland, SJ; Bañez, LL

Published Date

  • December 2011

Published In

Volume / Issue

  • 14 / 4

Start / End Page

  • 346 - 353

PubMed ID

  • 21727906

Pubmed Central ID

  • PMC5464754

Electronic International Standard Serial Number (EISSN)

  • 1476-5608

Digital Object Identifier (DOI)

  • 10.1038/pcan.2011.31


  • eng

Conference Location

  • England