I just found this on Medscape. Maybe you only need a DRE for play exams:
Digital Rectal Exam Fails as Screening Tool for Prostate Cancer
March 14, 2023
Digital rectal examination (DRE) is neither helpful nor useful as a solitary prostate cancer screening tool in middle-aged men, say investigators reporting the PROBASE study.
The study compared risk-adapted screening measures in men who had prostate-specific antigen (PSA) measured at age 45 with those who had PSA measurements plus DRE at age 50.
The results show that as a solitary screening tool, 99% of DREs did not raise suspicion for prostate cancer, and among the 57 cases where DRE did raise suspicion, only three men were found to have cancer, all of which were low-grade, reported Agne Krilaviciute, PhD, from the German Cancer Research Center in Heidelberg, and colleagues.
"We also see that the cancer detection rate by PSA is four times higher compared to the DRE detection. Around 18% of the tumors are located in the part of the prostate where DRE cannot detect them," she said in an oral presentation here at the European Association of Urology (EAU) Congress.
The investigators found that the majority of prostate cancers that occurred in this relatively young population were International Society of Urological Pathology (ISUP) grade 1 (Gleason score 3+3=6) or grade 2 (Gleason 3+4=7). DRE yields positive results in only about 12% of cases of ISUP grade 1 or 2, they noted.