From the Guidelines
Digital rectal exams (DRE) typically start at age 50 for average-risk men as part of prostate cancer screening. For men at higher risk, including African American men and those with a family history of prostate cancer, screening may begin earlier at age 45. The DRE involves a healthcare provider inserting a gloved, lubricated finger into the rectum to feel the prostate gland for abnormalities such as enlargement, hardness, or irregular areas that might indicate cancer. This exam is usually performed alongside a PSA (prostate-specific antigen) blood test for more comprehensive screening.
Key Points to Consider
- The American Cancer Society recommends that men with a life expectancy of at least 10 years should have an opportunity to make an informed decision with their healthcare provider about whether to be screened for prostate cancer, after receiving information about the potential benefits, risks, and uncertainties associated with prostate cancer screening 1.
- The timing of DRE screening is based on balancing early detection benefits against potential harms of unnecessary testing and treatment.
- Patients should discuss their individual risk factors with their healthcare provider to determine the appropriate age to begin screening.
- The exam is quick, taking only about 10-15 seconds, though it may cause momentary discomfort.
- Prostate cancer screening should not occur without an informed decision-making process 1.
From the Research
Digital Rectal Exam Testing Age
- The age at which digital rectal exam (DRE) testing typically starts is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that DRE is often used in combination with prostate-specific antigen (PSA) testing for the detection of prostate cancer in men, usually starting at the age of 50 3, 6.
- One study recruited healthy male volunteers between 50 and 70 years old for a public screening program 3.
- Another study included 408 consecutive patients referred with age-specific PSA levels of 2.5-10.0 ng/mL, with a mean age of 63.8 years 5.
- A study published in 1999 screened 22,513 community volunteers by PSA testing and digital rectal examination at 6-month intervals, but did not specify the starting age for DRE testing 6.
Screening Guidelines
- The studies do not provide a clear consensus on the age at which DRE testing should start, but they suggest that it is often used in men over 50 years old 2, 3, 4, 5, 6.
- The American Urological Association and other organizations recommend that men between 55 and 69 years old discuss the benefits and risks of prostate cancer screening with their doctor, but do not specify the age at which DRE testing should start 2, 3, 4, 5, 6.