ABSTRACT
PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.