Predictive value of digital rectal examination for prostate cancer detection is modified by obesity.
Summary of "Predictive value of digital rectal examination for prostate cancer detection is modified by obesity."
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-trends0.05) 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 (P0.032) but not normal-weight men (P0.198). 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.Prostate Cancer and Prostatic Diseases advance online publication, 5 July 2011; doi:10.1038/pcan.2011.31.
Affiliation
1] Division of Urologic Surgery and the Duke Prostate Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA [2] Department of Surgery, Urology Section, Veterans Affairs Medical Center, Durham, NC, USA.
Journal Details
This article was published in the following journal.
Name: Prostate cancer and prostatic diseases
ISSN: 1476-5608
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21727906
- DOI: http://dx.doi.org/10.1038/pcan.2011.31
Medical and Biotech [MESH] Definitions
Digital Rectal Examination
A physical examination in which the qualified health care worker inserts a lubricated, gloved finger of one hand into the RECTUM and may use the other hand to press on the lower ABDOMEN or pelvic area to palpate for abnormalities in the lower rectum, and nearby organs or tissues. The method is commonly used to check the lower rectum, the PROSTATE gland in men, and the UTERUS and OVARIES in women.
Prostate-specific Antigen
A glycoprotein that is a kallikrein-like serine proteinase and an esterase, produced by epithelial cells of both normal and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer.
Predictive Value Of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Fenretinide
A synthetic retinoid that is used orally as a chemopreventive against prostate cancer and in women at risk of developing contralateral breast cancer. It is also effective as an antineoplastic agent.
Ultrasound, High-intensity Focused, Transrectal
Tissue ablation of the PROSTATE performed by ultrasound from a transducer placed in the RECTUM. The procedure is used to treat prostate cancer (PROSTATIC NEOPLASMS) and benign prostatic hypertrophy (PROSTATIC HYPERPLASIA).
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