Is clinical examination for prostate cancer becoming redundant?

Prostate cancer is a paradigmatic example of the impact of technological change on current medical practice, because biological and radiological assessments appear more reliable compared to clinical examination. Thus, the prostate specific antigen blood-test is the key factor for patients' follow-up and for medical decisions. In this context, the possibility arises of medicine without clinical examination; and if, indeed, it would be ethical to perform clinical examinations such as digital rectal examination if it has no direct consequences for care. However, clinical examination could have a residual value for clinical practice, no more as a central factor for medical decision making, but as a key element in shaping the patient-physician relationship. Attention must be focused on identifying the changing role of clinical examination and on discussing its ethical acceptability.

Keywords: Prostate cancer, screening, urooncology, clinical examination, digital rectal examination, care relationship.