PSA test plus digital exam best at spotting prostate cancer

A combination of both the blood PSA test and the digital rectal exam appears to work best for detecting prostate cancer, according to early results from an ongoing study.

The study is part of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial being conducted by researchers at Washington University School of Medicine in St. Louis and several other institutions.

Overall, about 14 percent of men screened so far in the study tested positive for signs of prostate cancer. According to the researchers, eight percent of men tested positive on the PSA test, while positive findings were uncovered in seven percent of men via the digital rectal exam.

"We were hopeful some years ago that men could just have the PSA blood test, because men hate the rectal exam," Dr. Gerald L. Andriole Jr., head of the division of urologic surgery at Washington University and Barnes-Jewish Hospital, said in a prepared statement. "We've found that if you omit the digital rectal exam, you'll miss a certain percentage of cancers."

The study will continue until 2019 and should enable researchers to determine whether current prostate screening practices do reduce death from the disease.

"But the main thing is we don't know whether screening saves lives. Our study follows about 75,000 men, half of whom we are screening, and half of whom are getting conventional care. By comparing groups over the long term, we will see what difference screening makes in survival rates," Andriole said.

•	PSA Test Plus Digital Exam Best at Spotting Prostate Cancer ABC News online, Thursday, March 24, 2005

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