This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

LT Richard J. Ackermann, MC
USNR Naval Hospital Charleston, SC

JAMA. 1985;254(9):1171-1172.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Drs Chodak and Schoenberg¹ provide encouraging data that the digital rectal examination can detect early prostate cancer in asymptomatic men. However, we should not overinterpret their results.

The authors confuse specificity with predictive value. Eleven cancers were detected in 38 prostate biopsy specimens. Eleven (29% ) of 38 is not specificity, but the predictive value of a positive test result. As biopsy remains the gold standard for detection of prostate cancer, specificity cannot be determined because biopsies are not performed on men with normal prostate examinations. In this study, prostate biopsy yielded a diagnosis of cancer in 29% of cases. This actually is a reasonable predictive value for a screening program. But we have no data on sensitivity or specificity, and thus cannot calculate how many cancers are being missed by rectal examination.

I raise several other minor points. First, the examinations were performed by urologic specialists, yet . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?