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The Effect of the Clinical Digital Rectal Exam on the Complexed Prostate-Specific Antigen Versus the Total Prostate-Specific Antigen

15 February 2011


Background: The total serum prostate-specific antigen has been used as a screening tool to determine prostate health and is routinely done after a clinical exam which may include a digital rectal exam. The complexed prostate-specific antigen is a portion of the total prostate-specific antigen and may be a better indicator for prostate health. The purpose of this paper is to evaluate the effect that the digital rectal exam has on both the total prostate-specific antigen and the complexed prostate-specific antigen. The evidence will be evaluated using the GRADE system.

Method: An exhaustive search of available medical literature was conducted using Medline, Web of Science, Cochrane Systematic Reviews and CINAHL.

Results: There were four studies included in the review. The change in total and complexed prostate-specific antigen serum values in ng/mL post digital rectal examination was evaluated across the studies. Due to the fact that the complexed prostate-specific antigen is a subset of the total prostate-specific antigen the consequences of the digital rectal examination was compared using a percent change.

Conclusion: The complexed prostate-specific antigen is affected less by the digital rectal exam and would indicate that it may be a more reliable marker for prostate health compared to the total prostate-specific antigen. This recommendation needs to be used with caution as the overall GRADE of evidence was considered low and additional research is likely to have an impact on the confidence of the recommendation[TC1] .

[TC1]No references are included in the abstract.


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