The diagnostic value of digital rectal examination in primary care for palpable rectal tumour

Background: Digital rectal examination (DRE) is considered an important part of the physical examination. However, it is unclear how many patients have a DRE performed at the primary care level in the work-up of rectal cancer, and if the absence of a DRE causes a delay to consultation with a specialist. Methods: A retrospective patient questionnaire was sent to 1000 consecutive patients with stage II or stage III rectal cancer. The questionnaire asked patients to recall if they had a DRE performed by their general practitioner (GP) when they first presented with symptoms or a positive FIT test. Demographic data, staging data, and time to consultation with a specialist were also collected. Results: A thousand surveys were mailed out, and a total of 262 patients responded. Of the respondents, 46.2% did not recall undergoing a digital rectal examination by their primary care provider. Women were less likely to undergo a DRE than men (28.6% vs. 44.3%, p = 0.019). While there was a trend towards longer times to specialist consultation in patients who did not undergo a DRE (27.0 vs. 12.2 weeks), this was not statistically significant (p = 0.121). Conclusion: A significant proportion of patients who are FIT positive or have symptomatic rectal bleeding do not recall having a DRE by their primary care provider. Barriers may include lack of comfort with performing DRE or lack of time. Clearer guidelines and more support for GP’s may increase uptake of DRE.

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MP33-13 THE DIAGNOSTIC VALUE OF DIGITAL RECTAL EXAMINATION FOR PROSTATE CANCER: AN ANALYSIS OF OVER 20,000 BIOPSIES

The Journal of Urology ◽

10.1016/j.juro.2017.02.1009 ◽

2017 ◽

Vol 197 (4S) ◽

Cited By ~ 1

Author(s):

Lorenzo DiGiorgio ◽

Nitin Patel ◽

Vladislav Bargman ◽

Robert Weiss

Keyword(s):

Prostate Cancer ◽

Digital Rectal Examination ◽

Diagnostic Value ◽

Rectal Examination

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Occult adenocarcinoma in adenomas. Possibilities of diagnostic methods

Koloproktologia ◽

10.33878/2073-7556-2021-20-2-10-16 ◽

2021 ◽

Vol 20 (2) ◽

pp. 10-16

Author(s):

S. V. Chernyshov ◽

E. A. Khomyakov ◽

R. K. Sinitsyn ◽

Yu. E. Vaganov ◽

Yu. L. Trubacheva ◽

...

Keyword(s):

Anal Verge ◽

Digital Rectal Examination ◽

Diagnostic Value ◽

Diagnostic Methods ◽

Pelvic Mri ◽

Rectal Examination ◽

Occult Malignancy ◽

Endoscopic Microsurgery ◽

Pair Wise Comparison

Aim: to analyze the diagnostic value of the digital rectal examination, colonoscopy, MRI and ERUS for detecting occult adenocarcinoma in rectal adenomas.Patients and methods: the study included 100 patients with newly identified epithelial rectal neoplasms, which undergone transanal endoscopic microsurgery from December 2019 to December 2020. All the patients underwent digital rectal examination, colonoscopy, ERUS with sonoelastography, and pelvic MRI. The diagnostics value of this methods was estimated with determination of sensitivity and specificity.Results: the study included 67 (67%) females and 33 (33%) males. The mean age of the patients was 64.4 ± 10.7 years. The median distance from the tumor to the anal verge was 6.0 ± 2.9 cm. The sensitivity of the digital rectal examination in the occult malignancy verification was 0.44 (95% CI 0.24–0.65), specificity — 0.93 (95% CI 0.85–0.97). The sensitivity of the colonoscopy — 0.56 (95% CI 0.34–0.75), the specificity — 0.84 (95% CI 0.73–0.91). The sensitivity of MRI — 0.40 (95% CI 0.21–0.61), specificity — 0.89 (95% CI 0.80–0.95). The sensitivity of ERUS was 0.48 (95% CI 0.27–0.68), the specificity — 0.73 (95% CI 0.61–0.82). Pair wise comparison of diagnostic methods revealed the absence of significant differences in their diagnostic value (p > 0.05).Conclusion: at least one of diagnostic methods allows to verify the presence of malignant transformation in 100% of cases. So, only combination of diagnostic methods can help to choose the optimal treatment option.

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