ABSTRACT
Background Prostate cancer is the fourth most common cancer worldwide. In men it is the most common malignant tumor, accounting for approximately one-third of all cancer diagnosis; in the United States 230 000 new cases were diagnosed in 2004.1
Prostate cancer has a variable biology, ranging from indolent low grade to spreading aggressiveness and a tendency to metastasize finally. Characteristically it originates in the peripheral zone. Since this part of the gland is attached to the anterior rectal wall, palpation of the prostate during digital rectal examination (DRE) is a cornerstone in the diagnosis and local staging of prostate cancer. DRE has a sensitivity of 52% and a specificity of 81% for the prediction of organ-confined disease.2 In DRE, which is sometimes subjective and poorly reproducible, very often understaging and overstaging will be seen.
