Cancer: Digital Rectal Examination for Prostate Problems

Doctors use the digital rectal exam (DRE) as an early and relatively simple test to screen for prostate cancer. The goal is to detect the cancer in its early stages, when treatment is most successful.

The digital rectal exam is typically done during a standard physical exam for men. Because the prostate is an internal organ, your doctor cannot look at it directly. But since the prostate lies in front of the rectum, he or she can feel it by inserting a gloved, lubricated finger into your rectum.

Who Should Get a Digital Rectal Exam?

Not all medical institutions agree on when men should begin screening (routine testing) for prostate cancer. But, as is the case with most other types of cancer, early detection often means more treatment options are available and less extensive treatment is necessary to be successful.

To help detect prostate cancer in its early stages, the American Cancer Society advises offering annual screening starting at age 50 to men who have at least a 10 year life expectancy. They encourage men who are at high risk, such as African-American men and men with a family history of prostate cancer, to begin screening at age 45. Men at an even higher risk, such as having several relatives with a history of prostate cancer at an early age, could begin testing at age 40. The American Urological Association agrees that annual screening should begin at age 50 but encourages men in high risk groups, such as African-Americans or those with a family history, to begin screening at age 40 as opposed to 45.

The doctors at the Cleveland Clinic recommend screening for prostate cancer with the digital rectal exam annually for all men beginning at age 45. The DRE is recommended with the PSA blood test for the following men:

• All men beginning at age 50
• African American men beginning at age 40
• Men with a family history of prostate cancer, beginning at age 40 (or younger, if recommended by a doctor)
• Men who develop persistent urinary symptoms

Following these screening guidelines may help identify prostate cancer earlier.

What Happens During a Digital Rectal Exam?

Your healthcare provider will insert a gloved finger into the rectum and feel the prostate for hard, lumpy, or abnormal areas The test takes only a few minutes to complete.

You may feel slight, momentary discomfort during the test. The procedure does not cause significant pain or any damage to the prostate.

What Happens After the Digital Rectal Exam?

You may go on with your normal activities. Your doctor will discuss the test results with you. If he or she detects a suspicious lump or area during the exam, or if your PSA level is elevated, an ultrasound-guided biopsy may be the next step.

Reviewed by the doctors at The Cleveland Clinic Urological Institute.