The prostate cancer detection rate from screening by digital rectal examination and tactilely guided prostate biopsy is approximately 1.7%. Among 1,807 men a detection rate of 14.6% was achieved in a clinical urological practice by physician-conducted prostate ultrasonography, digital rectal examination and determination of serum prostate specific antigen. Results are presented in 5-year increments as well as for the group as a whole. The possible benefit to be derived from an improved detection rate is undetermined. Recommendations are made regarding the clinical use of these diagnostic modalities.

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We reviewed 225 men who were followed for 2 to 21 years by periodic rectal examination in an effort to detect prostatic cancer without the glands having been sufficiently suspicious for biopsy to have been recommended. These patients underwent further evaluation with transrectal prostatic ultrasonography and serum prostate specific antigen determinations. When appropriate, ultrasonically guided transrectal needle biopsy of the prostate was performed without analgesia, anesthesia or prophylactic antibiotics. This is a simple, safe and effective means to obtain tissue for diagnosis. Recommendations for the current applicability of these diagnostic modalities by the practicing urologist are given.

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