Digital Rectal Exam (DRE)

A digital rectal exam examines the lower part of the rectum.

During a digital rectal exam, a doctor puts on a glove with lubrication on it. Then she or he inserts a finger ("a digit") into your rectum to feel for abnormalities such as hard or lumpy areas. 

Advantages to a Digital Rectal Exam

• Often performed as part of a routine physical examination.
• No advance cleansing of the colon and no dietary restrictions are necessary.
• The test is usually quick and painless.
• Less costly than other methods.

Disadvantages to a Digital Rectal Exam

• The test can only detect abnormalities in the first 2 - 3 inches of the rectum and is dependent on the examiner's technique and response.
• Cancerous polyps usually cannot be identified during a digital rectal exam. Additional procedures such as colonoscopy are needed if abnormalities are noted.
• There may be slight, momentary discomfort during the test.

What Happens If A Doctor Finds Abnormalities During A Digital Rectal Exam

Depending on your particular situation, the gastroenterologist may then use one or more of the following techniques to determine if you have colorectal cancer. Which test(s) will be used next depends on your individual situation. 

• Colonoscopy Colonoscopy is used most often. In addition to identifying abmornalities, it allows for them to be removed at the same time. 
• Fecal or stool tests. There are 3 fecal or stool tests in use today:
  • Fecal occult blood test (FOBT)
  • Fecal immunochemical test (FIT)
  • Stool DNA test (sDNA)
• Sigmoidoscopy

If one of the above tests indicates that cancer is present, one of more of the following tests can show whether the cancer has spread to other parts of the body:

• A biopsy
• Blood tests
• Chest X-Ray
• CT scan
• Double Contrast Barium Enema (DCBE)
• Endoscopic ultrasound (EUS)
• Liver function tests which indicates the overall health of the liver for receiving treatment and if the cancer has spread to the liver how compromised the liver may be.
• MRI scan
• PET Scan

If type II colon cancer is present, an Oncotype DX test may be recommended.

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