Digital rectal examination in prostate cancer screening at PSA level 3.0-3.9 ng/ml: long-term results from a randomized trial

Figures & data

Table 1. Number and proportion of men invited and participating at the first screening round by year of invitation, age, and family history of prostate cancer in the FinRSPC trial.

	Invitees N (%)*	Attendees N (%)^#
Year of invitation
1996	7,268 (24.1)	5,034 (69.3)
1997	7,639 (25.4)	5,244 (68.6)
1998	7,632 (25.3)	5,364 (70.3)
1999	7,581 (25.2)	5,098 (67.2)
Age (years)
55	9,884 (32.8)	6,434 (65.1)
59	7,890 (26.2)	5,537 (70.2)
63	6,537 (21.7)	4,717 (72.2)
67	5,809 (19.3)	4,052 (69.8)
Family history of prostate cancer
Affected 1st degree relative(s)	1,715 (5.7)	1,544 (90.0)
No family history	21,939 (72.8)	19,149 (87.3)
Missing	6,466 (21.5)	47 (0.7)
Total	30,120 (100.0)	20,740 (68.9)

*Column percentage; ^#Row percentage (of those invited).

Table 2. Number and proportion of men at the first screening round by prostate specific antigen (PSA) level, ancillary test result including the digital rectal examination (DRE)* finding and free/total PSA ratios^# and number of prostate cancers (PC) by the time of detection in the FinRSPC trial.

1st round screening test results	Attendees N (%)	PCs detected in the 1st screening round N (%)	PCs detected at later screenings N (%)	PCs diagnosed after the screenings N (%)	PCs total N (%)
PSA 2.0–2.9 ng/ml	2,156 (56.4)	3 (0.14)	411 (19.1)	166 (7.7)	580 (26.9)
Normal DRE finding	102 (4.7)	NA	12 (11.8)	13 (12.7)	25 (24.5)
Suspicious DRE finding	7 (0.3)	3 (42.9)	1 (14.3)	0 (0.0)	4 (57.1)
DRE not performed	2,047 (94.9)	NA	398 (19.4)	153 (7.5)	551 (26.9)
PSA 3.0–3.9 ng/ml	1,067 (27.9)	33 (3.1)	289 (27.1)	78 (7.3)	400 (37.5)
Normal DRE finding	649 (60.8)	NA	173 (26.7)	57 (8.8)	230 (35.4)
Suspicious DRE finding	82 (7.7)	18 (22.0)	20 (24.4)	2 (2.4)	40 (48.8)
Free/total PSA ratio <0.16	60 (5.6)	15 (25.0)	17 (28.3)	4 (6.7)	36 (60.0)
Free/total PSA ratio ≥0.16	211 (19.8)	NA	65 (30.8)	12 (5.7)	77 (36.5)
No supplementary test	65 (6.1)	NA	14 (21.5)	3 (4.6)	17 (26.2)
PSA 4.0–4.9 ng/ml	597 (15.6)	107 (17.9)	107 (17.9)	31 (5.2)	245 (41.0)
Total	3,820 (100.0)	143 (3.7)	807 (21.1)	275 (7.2)	1,225 (32.1)

*DRE offered to all men with PSA 3.0–3.9 ng/ml during 1996–1998 and to 119 men with PSA 2.0–2.9 ng/ml in 1996.

^#Determined from all men with PSA 3.0–3.9 ng/ml during 1999.

NA: not applicable.

Table 3. The number and proportion of prostate cancers (PC) by EAU risk classification and ancillary test result including the digital rectal examination (DRE) finding and free/total (F/T) PSA ratio.

	Normal DRE N (%)	Suspicious DRE N (%)	F/T PSA ≥ 0.16 N (%)	F/T PSA < 0.16 N (%)	Total N (%)
Low risk	112 (17.3)	19 (23.2)	41 (19.4)	21 (35.0)	193 (19.3)
Intermediate risk	72 (11.1)	11 (13.4)	25 (11.8)	11 (18.3)	119 (11.9)
High risk	44 (6.8)	10 (12.2)	9 (4.3)	3 (5.0)	66 (6.6)
Missing	2 (0.3)	0 (0.0)	2 (0.9)	1 (1.7)	5 (0.5)
All PCs	230 (35.4)	40 (48.8)	77 (36.5)	36 (60.0)	383 (38.2)
No. of men	649 (100.0)	82 (100.0)	211 (100.0)	60 (100.0)	1002 (100.0)

Figure 1. Prostate cancer (PC) incidence rate ratios (IRR) for different first-round screening results adjusted for age, family history of PC and place of residence in PSA range 3.0–3.9 ng/ml. The first-round prostate cancer IRRs were excluded from the table due to the strong correlation between diagnosis and the test leading to the diagnosis. (A) Later round PC, (B) post-screening PC, (C) PC during any round including the first and (D) all PCs. DRE: digital rectal examination; F/T: free/total.