What is a digital rectal exam (DRE)?

Nancy Ferrari

Senior editor, Harvard Health

In this test, commonly performed as part of prostate cancer screening, a doctor inserts a lubricated, gloved finger into the rectum and feels the surface of the prostate to determine whether it is swollen or has any lumps or abnormally textured areas (see illustration below).

Although this exam generally takes less than a minute, some men find it uncomfortable and, most of all, embarrassing, so they postpone it or avoid going to a physician altogether. But the discomfort is mild and lasts only a few moments, and the procedure causes no physical injury.

The DRE is a useful screening test, but it isn’t foolproof. Its accuracy depends on the skill of the physician conducting and interpreting the test. Moreover, early cancerous tumors are often too small to detect during a DRE, and some are located in areas a doctor’s finger can’t reach. For these reasons, clinicians who use DRE alone to screen for prostate cancer sometimes miss the smallest and most treatable tumors. On the other hand, small tumors that can’t be felt by the physician may be less likely to cause future problems.

Digital rectal exam

Digital rectal exam

To perform a digital rectal examination (DRE), the doctor inserts a lubricated, gloved finger into the rectum and presses against the rectal wall to determine the size of the prostate and feel for irregularities. Early-stage cancer may be felt as a small lump on the surface of the prostate.

Originally published March 2009; last reviewed March 1, 2011.

Comments:

  1. Bill Gaffney

    What if a G.P. doesn’t do a DRE for a man with a PSA of 10 and is over 70 years old?

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