SCREENING FOR PROSTATE-CANCER BY DIGITAL RECTAL EXAMINATION AND PROSTATE-SPECIFIC ANTIGEN - RESULTS OF PROSTATE-CANCER AWARENESS WEEK, 1989-1992

Objective. To evaluate the use of digital rectal examination (DRE), pr ostate specific antigen (PSA), and age-specific reference values for P SA when screening for prostate cancer in a national screening program. Methods. Data collected during Prostate Cancer Awareness Week (PCAW), 1989-1992, were used for comparing DRE and PSA. Results. More than 1, 000,000 men were screened at 4141 sites from 1989-1992. The rate of ab normal DRE for all 4 years was 13.1%, and the rate of elevated PSA (> 4.0 ng/mL) was 14.4% for the same period. PSA proved superior to DRE i n sensitivity, positive predictive value, and accuracy in making a can cer diagnosis. Screening resulted in 77.7% of diagnosed cases being de termined as clinically localized disease. Age-specific PSA reference v alues added a slight improvement in sensitivity at lower ages and an i mprovement in positive predictive value in older men. Conclusions. Dat a from PCAW establish the success of national prostate cancer screenin g and suggest that further refinements with age-specific PSA reference values may improve overall results.