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Repeated screening for carcinoma of the prostate by digital rectal examination in a randomly selected population
E Varenhorst1, P Carlsson, E Capik
1Department of Urology, County Hospital, Norrköping, Sweden.
Abstract:
Of 9,026 males aged 50-69 years, 1,494 were randomly selected and invited to participate in a programme including two screenings for carcinoma of the prostate by digital rectal examination performed in 1987 and 1990. The remaining 7,532 served as a control group. Of the selected persons, 78% accepted the invitation to the first screening round and 70% to the second one. Carcinoma of the prostate was suspected in 45 of 1,163 men examined at the first screening round and in 42 of 953 at the second round. Carcinoma was confirmed by fine-needle aspiration biopsy in 13 cases from the first and in 7 from the second round. In the study group, 17.4 carcinomas were diagnosed per 1,000 men and in the control group 8.6 per 1,000 men. The screening cost was 1,640 pounds per detected cancer and 2,343 pounds per detected and potentially cured cancer. Screening for carcinoma of the prostate by digital rectal examination can be organised with a high population acceptance, and at a reasonable cost. The impact of screening on mortality in prostatic cancer remains uncertain.
Insights
Screening for prostate cancer using digital rectal exams in men aged 50-69 showed high acceptance and reasonable costs. However, the impact of this screening on prostate cancer mortality remains uncertain.
Area of Science:
- Urology
- Public Health
- Oncology
Background:
- Prostate cancer screening is crucial for early detection.
- Digital rectal examination (DRE) is a common screening method.
- Assessing the feasibility and cost-effectiveness of DRE screening programs is important.
Purpose of the Study:
- To evaluate the population acceptance and cost-effectiveness of a prostate cancer screening program using DRE.
- To determine the number of prostate cancer cases detected through DRE screening.
Main Methods:
- A randomized screening program involving two DREs over three years was conducted.
- 1,494 men aged 50-69 were invited for screening, with 7,532 serving as a control group.
- Prostate cancer was diagnosed via fine-needle aspiration biopsy.
Main Results:
- The screening program achieved high participation rates (78% and 70%).
- Prostate cancer was detected at a rate of 17.4 per 1,000 men in the screened group versus 8.6 per 1,000 in the control group.
- The cost per detected cancer was £1,640, and per potentially cured cancer was £2,343.
Conclusions:
- DRE screening for prostate cancer can be organized with high population acceptance and at a reasonable cost.
- The study highlights the potential of DRE in increasing prostate cancer detection rates.
- Further research is needed to ascertain the impact of DRE screening on prostate cancer mortality.
