Rectal exam is a ‘poor test for prostate cancer’, say surgeons

We’re standing side by side with the UK’s top surgeons and calling for an end to the routine use of the digital rectal exam – because a ‘finger up the bum’ is no longer a useful test for prostate cancer. 

The British Association of Urological Surgeons (BAUS) has pledged to work with NHS bosses to advise GPs that men with suspected prostate cancer don’t need to have a rectal exam before being referred for further tests. 

Men should instead be referred for an MRI scan, which will give a more accurate indication of whether they have cancer. 

We’ve joined forces with BAUS to shine a light on this issue and push for a change to GP guidance. 

Our call for action follows new data showing the rectal exam is still being offered to men – despite its poor ability to detect cancer. 

In a recent survey of men who completed our online Risk Checker, around 750 men said they’d asked their GP for a PSA blood test. A third of these men were offered a rectal exam as well as a blood test – and alarmingly, three per cent were offered the exam instead of a blood test.

Looking for more information? Get the answers to some of the most common questions about the rectal exam and why we say it’s now a “poor test” for prostate cancer. 

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MRI scans and new biopsy techniques have improved prostate cancer diagnosis

With the rectal exam, a clinician is only able to feel the back wall of a man’s prostate - so any abnormalities in the middle or at the front, which would be picked up by an MRI scan, can be easily missed.

Last year a group of prostate cancer experts published a landmark paper that agreed the rectal exam is not a useful test for finding the disease – and their conclusion was backed up by the latest NHS medical guidance. 

Thankfully, the way prostate cancer is diagnosed has improved significantly in recent years with the introduction of MRI scans and new biopsy techniques. And today, the process of diagnosing the disease is safer and more accurate than ever before. 

“Emerging evidence confirms that the digital rectal exam is a poor test,” says Vishwanath Hanchanale, Chair of Section of Oncology at BAUS.  

“Yet its continued presence in referral guidelines is causing confusion and anxiety – putting men off seeking help and ultimately delaying lifesaving diagnoses. 

“It’s important that NHS pathways continue to evolve in line with the latest evidence, ensuring men receive the most accurate and effective care.”

You don’t need a finger up the bum to test for prostate cancer

The ‘finger up the bum’. For far too long it’s been part of the conversation about prostate cancer.  

But not only is it ineffective at finding the disease, it’s also putting men off speaking to their GP about testing. And condemning many to a later diagnosis, when their cancer may be incurable.  

We know discomfort about having a rectal exam is the biggest barrier stopping men from talking to their GP about the PSA blood test. And Black men – whose risk is double that of other men – report that they feel an even greater sense of stigma about the procedure. 

So what’s our message to men? Know your risk of prostate cancer by taking our quick and easy online Risk Checker. And if you decide to talk to your GP about testing, know that you can ask to have a simple blood test. You don’t need a finger up the bum to test for prostate cancer. 

“Even though experts agree it’s a poor test that should now be consigned to history, the spectre of the rectal exam is still making men think twice about going to their GP,” said Amy Rylance, our Assistant Director of Health Improvement. 

“If you’re a man reading this, just remember you don’t need a finger up the bum to test for prostate cancer. It’s a simple blood test. Find out your risk in 30 seconds using our online Risk Checker.” 

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