WASHINGTON, D.C.—Obese men are less likely to have an abnormal digital rectal examination (DRE) than non-obese men, according to findings presented at the American Urological Association 2011 annual meeting.

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An abnormal DRE in obese men, however, increases their risk for prostate cancer (PCa) overall and possible increases their risk of high-grade PCa compared with overweight and normal-weight men, said investigator David I. Chu, MD, of the Duke Prostate Center at Duke University Medical Center in Durham, N.C.

The findings, he said, call into question updated PCa screening guidelines from the American Cancer Society, which state that a DRE is optional.

“Even though a DRE may be more difficult to perform [on obese men] due to anatomic girth or body habitus, it may still need to be done … because of their higher risk,” Dr. Chu told Renal & Urology News.

The study by Dr. Chu and his colleagues included 2,803 men undergoing initial prostate biopsy at three centers: the Duke Prostate Center (1,145 men), the Durham Veterans Affairs Medical Center (942 men), and La Sapienza University in Rome, Italy (716 men).

An abnormal DRE increased the likelihood of finding PCa on biopsy by two- to three-fold among obese men compared with normal-weight men. In the Italian cohort, an abnormal DRE also significantly increased the risk of high-grade PCa in obese men relative to normal-weight men.