An evaluation of serial digital rectal examinations in screening for prostate cancer.

The purpose of this review is to test the hypothesis that serial digital rectal examinations of the prostate lead to detection of prostate cancer at an earlier and more curable stage. The clinic records of 4,843 patients between 40 and 79 years old seen at the Brooke Army Medical Center prostate cancer screening clinic between January 1979 and September 1985 were reviewed. Of the patients with palpable nodules 122 were found on biopsy to have adenocarcinoma of the prostate. We compared the clinical and, when possible, pathological stage of disease diagnosed at the initial clinical visit to those from patients who had prior normal digital rectal examinations at the screening clinic and who were followed at our clinic. There was a numerically striking difference in the percentage of patients in each group with clinical as well as pathological stage B cancer. Due to the small number of patients in each group these differences were not statistically significant.