Digital Rectal Examination (DRE) for Prostate Cancer

A digital rectal examination (DRE), performed as part of an annual physical checkup, is one of the most important tests for the early detection of prostate cancer. Because the prostate gland is located just in front of the rectum, it cannot be felt from the outside of the body.

During the DRE, a doctor inserts a lubricated, gloved finger into the patient's rectum to feel for lumps, enlargements, or areas of hardness that might indicate prostate cancer. The procedure lasts for less than minute and, while uncomfortable, should cause no pain. However, a painful examination could indicate the presence of other, benign conditions, such as prostatitis.

Why Do I Need a Digital Rectal Examination?

Most early prostate cancers cause no symptoms and are found only through early detection by a digital rectal examination and a prostate-specific antigen (PSA) test. Recent studies indicate that the combination of DRE and PSA testing is more effective in the early detection of prostate cancer than either procedure is on its own.

Does a DRE Always Detect Prostate Abnormalities?

A digital rectal examination allows a doctor to feel only the back wall of the prostate gland, so any abnormalities located in the middle or front part of the gland cannot be felt. For this reason, the DRE is performed in conjunction with PSA testing. Although the PSA test can detect many cancers which doctors cannot feel during a DRE, it has also been shown that DREs detect some cancers which are not associated with an elevated level of PSA in the bloodstream.

How Often Do I Need a DRE?

As part of the annual checkup, the American Cancer Society recommends digital rectal examinations and PSA testing for:

• Men 50 and older with a life expectancy of at least 10 years.
• Younger men at increased risk for prostate cancer, including:
  • Men with a close male relative (father, brother, uncle, grandfather) with prostate cancer.
  • African American men.

The Prostate Cancer pages of this website are part of the Comprehensive Prostate Cancer Awareness Program (CPCAP), a major regional effort to reduce the rates of death and illness caused by prostate cancer in southwestern Pennsylvania. Funding for CPCAP is provided by a grant from the Commonwealth of Pennsylvania.