A digital rectal examination (DRE) (often called a prostate exam in men) is an internal examination performed by a healthcare provider using a lubricated, gloved finger inserted into the rectum. It helps assess:

• Rectal wall, masses, or abnormalities
• Anal sphincter tone
• In men, the size, shape, consistency, and nodularity of the prostate
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Diagnostic Uses

1. Prostate Assessment in Symptomatic Patients

• The DRE is used in patients presenting with urinary symptoms (e.g., frequency, urgency, hesitancy, nocturia) to check for abnormalities suggestive of prostate cancer.
• According to a systematic review of primary care use:
  • Sensitivity: ~28.6% (i.e., DRE misses many cancers)
  • Specificity: ~90.7% (i.e., positive findings are likely meaningful)
  • Positive Predictive Value (PPV): ~42.3%
  • Negative Predictive Value (NPV): ~84.2%
    PMC
  In other words:
  • A positive DRE is a strong indicator warranting urgent referral (per UK NICE guidelines).
  • A negative DRE, however, still leaves a significant risk (~16%) of underlying malignancy—above the referral threshold.
    Therefore, decisions to refer should be based on symptoms, not DRE alone.
    PMC

2. Rectal and Anal Pathology