Why would I need this test?

The digital rectal exam (DRE) is a screening tool to detect rectal cancer and prostate cancer. This test is often called a rectal exam or prostate exam. The American Cancer Society recommends everyone older than 40 have an annual digital rectal exam.

How do I prepare for this test?

No special preparation is necessary for the examination.

How is this test performed?

A doctor inserts a gloved, lubricated finger into the patient's rectum and examines the rectal wall surface for lesions, or for an abnormally firm area that might indicate cancer. In men, the doctor also examines the size and characteristics of the prostate. The prostate gland is next to the rectum, and most cancers begin in the part of the gland that can be reached by a rectal exam. The doctor may also obtain a stool sample to check for the presence of blood in the stool (fecal occult blood test).

How long does the procedure take?

A DRE takes a few minutes.

What happens if an abnormality is found?

Because the DRE is a screening tool, more testing is needed if an abnormality is detected. If a suspicious lump or area is found and the doctor suspects a prostate problem, you need a protein-specific antigen blood test, transrectal ultrasound or a biopsy of the prostate. If a rectal problem is suspected, more examinations will be recommended.

About half of the time, a suspicious lump in the prostate or rectum is not cancer.

Are there any risks associated with this test?

No risks are associated with the exam. However, it is possible to get normal results that miss rectal bleeding or a positive result for blood that is false. This test does not rule out a problem definitively.

What is a desirable result?

The rectum should feel smooth without abnormalities or unusual lumps, swelling or tenderness. The prostate should be symmetrical, about the size of a walnut, and lack any nodules.