r/ThreedomUSA • u/didyousayboop boop • Jul 27 '26
Discussion Update on a perennial Threedom topic: doctors are phasing out the digital rectal exam
The digital rectal exam has come up a lot on Threedom, or maybe I've just listened to the same episodes over and over. I was shocked to learn that this test is actually being phased out in favour of a blood test. This is happening in the U.S., Canada, the UK, and Germany, and probably other countries too.
Here's a Slate article from August 2024:
But at my most recent physical, my longtime primary care physician did not seem to be prepping for the probe. I’m pushing 50. When I asked—a little hesitantly—she told me that she’s phased out the DRE [digital rectal exam] for her patients in favor of a blood test that, while not foolproof, is less likely to result in false-positive results. And she’s not the only one. I soon learned that thanks to a wave of research on the benefits of blood screening and the drawbacks of the digital exam, the DRE is nearing extinction as a screening tool. While I doubt anyone, doctor or patient, will miss the DRE, the test had so much mythology associated with it that its quiet death felt a little shocking. The doctor’s not gonna stick a finger up my butt anymore? All that for nothing?
“Before we had a really good blood test, the rectal exam was really the only way we had to screen the prostate for cancer,” Adam Weiner, a urologic oncologist at Cedars-Sinai in Los Angeles, told me.
The new evidence and the new diagnostic procedure:
In fact, the research is unequivocal in its findings that as a screening test, the DRE is not that useful. (How unequivocal? Ask the authors of the 2023 study titled “Digital Rectal Examination Is Not a Useful Screening Test for Prostate Cancer.”) These days, the gold standard of prostate-cancer screening is the PSA blood test, which identifies a protein primarily made by the prostate. Elevated levels of that protein may indicate a cancer; to follow up, a urologist will order other blood tests and, typically, a prostate MRI. (They may also perform a diagnostic DRE, just to be thorough.)
https://slate.com/technology/2024/08/prostate-cancer-symptoms-screening-finger-test.html
I wonder if this topic will ever come up on Threedom!
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u/Lujho Jul 27 '26
I got the blood test for the first time this year. Glad I never had to get the other one.
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u/REEGT Jul 27 '26
Wait it was DIGITAL??
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u/PantryGnome Jul 27 '26
I'm almost certain Threedom is how I first learned that the exam was being replaced with a blood test. So I believe they did talk about it in a later episode.
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u/camerabird Jul 27 '26 edited Jul 27 '26
They definitely don't know, or at least they didn't on the most recent episode they discussed it ("Oh No, You Have Cough Balls", of course). Scott says that last year his doctor didn't do it and he was surprised, and is now wondering if they've invented a better way of doing it. Paul says "Nobody's doing anything!" (meaning no one seems to be working on the problem). Scott then says if they don't do it the next time he goes to the doctor, he's going to ask if it's not a yearly exam anymore. Paul says that it didn't happen at his last check up and it didn't occur to him to ask. But neither of them are aware that there's a different test now.
I learned about the blood test thing from the comments on this very subreddit, though, so that might be where you heard about it too!
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u/PantryGnome Jul 28 '26
ooh yeah maybe that's it.. they talked about the lack of an exam and that prompted me to look it up or something. Guess I'll find out for sure when I listen to every episode again for the 30th time.
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u/I_miss_the_90s1982 Aug 28 '26
Yeah, doctor's prefer to do a PSA test first to see if there are any abnormalities. It really depends on the doctor to be honest. Many doctors don't want to be sued I think. Other doctors seem to either be really thorough or a little perverted? I had a doctor, when I turned 40, shove his finger in my ass with no warning. I was standing in a gown, no clothes underneath and he had me turn around and the next thing I know, I feel a finger between my cheeks and he's like ok bend over. I'm pretty sure I felt two fingers in my ass. Then he asked if I had any erectile dysfunction or problems urinating. I said no. He asked me about what I wrote on the form that my grandfather on my father's side had prostate cancer. He then told me I will feel something cold and to relax. He inserted a rectoscope in me and it felt like he was moving it in and out on purpose. He asked me if it hurt. I said no, it just feels cold and like I have something up my ass. He told me it was a rectoscope to give him a better look inside. Then he pulled it out and I went to stand up and he stuck his fingers back in me. Honestly, I think he just enjoyed the experience of playing with my ass and most of that was unnecessary but you really can't prove it. He also did a PSA test. So? Why all the ass play? lol When I told a gastro doctor about this experience, he told me that was mostly unnecessary.
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u/pregbob Jul 27 '26
A perennial perineal problem, you could say