However, symptoms of BPH associated with urinary tract obstruction are similar to those of prostate cancer. It should be remembered that some men with BPH will have mildly elevated PSA levels. TRUS does provide an excellent means of guiding transrectal biopsies of the prostate. Evaluation of a patient with an abnormal DRE Digital rectal examination is easy to perform and is the traditional test to detect changes in the prostate gland. DRE is useful in detecting other colorectal disease.
Suspicion arises when irregularities are found in the prostate gland.
However, DRE has a limited sensitivity and specificity in the detection of prostate cancer. A suspicious DRE is an indication for serum PSA testing. Evaluation of a patient with risk factors for prostate cancer African-American men and men with first degree relatives diagnosed before the age of 70 have a higher risk than the general population. However there is no evidence to suggest that early detection efforts will provide more benefit to such individuals than to normal risk patients. One study revealed, however, that when presented with information about PSA testing, patients with risk factors show a greater interest in pursuing PSA screening than those with no risk factors.