ArticleBMC medical education2026
Assessing digital rectal examination and prostate-specific antigen knowledge: a study of Syrian medical students' knowledge for prostate cancer screening.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProstate cancer (PCa) is a global health issue, and its early detection is crucial. In post-conflict Syria, the role of future physicians in managing non-communicable diseases is paramount. However, the preparedness of Syrian medical students to handle PCa screening is unknown. This study aims to assess the knowledge, attitudes, and perceived competence regarding PCa, Digital Rectal Examination (DRE), and Prostate-Specific Antigen (PSA) testing among senior medical students at the University of Damascus.
methodsA descriptive, cross-sectional study was conducted among 641 clinical-year (fourth, fifth, and sixth year) medical students using a validated, self-administered questionnaire. A two-stage cluster sampling technique was employed. The questionnaire assessed sociodemographic data and specific knowledge of DRE and PSA. Data were analyzed using independent t-tests and one-way ANOVA to identify significant differences across demographic and academic variables.
resultsA significant dissonance was found between theoretical awareness and practical knowledge. While awareness of DRE (98.1%) and PSA (97.2%) was nearly universal, practical experience was exceptionally low, with only 1.4% of students having ever performed a DRE. Knowledge of DRE procedures was significantly higher in male students than female students (p < 0.001). A paradoxical trend was observed wherein DRE knowledge increased from the fourth to the fifth year but declined in the final (sixth) year (p < 0.001). The most critical finding was a profound deficit in the clinical interpretation of PSA values; while 34.3% knew the normal range for Total PSA, knowledge of the Total/Free PSA ratio (16.5%) and Free PSA (11.2%) was alarmingly poor. A family history of PCa did not correlate with higher knowledge scores.
conclusionSenior medical students at Damascus University exhibit a critical theory-practice gap in PCa screening. They are aware of the screening modalities but lack the practical and interpretive knowledge essential for clinical competence. This deficit highlights an urgent need for curricular reform, emphasizing hands-on training and clinical reasoning to ensure the next generation of Syrian physicians is adequately prepared to manage this prevalent disease.
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