Prostate Cancer Detection by Using Digital Rectal Examination: Contemporary Practice Patterns in the United States

Current practice in digital rectal examination (DRE) for prostate cancer screening in the United States is poorly defined. We used the Behavioral Risk Factor Surveillance System to survey 110,661 men and found that 36.8% of men reported having an up-to-date DRE within the past year. Demographic and socioeconomic characteristics strongly influenced the likelihood of a man having an up-to-date DRE. Background: Digital rectal examination (DRE) may play an important role as a secondary method of prostate cancer detection if prostate-specific antigen (PSA) screening decreases. Current practice patterns in the use of DRE are not well defined, and potential variations in its use among different subgroups of men are unclear. Materials and Methods: The Behavioral Risk Factor Surveillance System was examined for the year 2010. All men aged 40 years old or older were asked if they ever had a rectal examination to check their prostate and the date of their last examination. Men who reported having had a DRE within the past 12 months were considered up to date. The proportion of men who reported having had a DRE and independent demographic and socioeconomic predictors for having had a DRE were determined. Results: A total of 110,661 respondents were included: 72.2% of respondents reported ever having had a DRE; 36.8% had had a DRE within the past year, and 49.7% within the past 2 years. On multivariate analysis for reporting having an up-to-date DRE, older men, those with higher body mass index, and those of black race were more likely to have an up-to-date DRE. Asian or Hispanic race, divorced or widowed marital status, lower education, lower income, and lack of health insurance were independently associated with being less likely to have an up-to-date DRE. Conclusions: Of American men, 36.8% reported having an up-to-date DRE within the past year and 49.7% of men within the past 2 years. Demographic and socioeconomic characteristics were strongly associated with the likelihood of having an up-to-date DRE. (C) 2013 Elsevier Inc. All rights reserved.