To the Editor.
—In their cost analysis, Dr Krahn and colleagues1 reject DRE as being less cost-effective than other methods, estimating the undiscounted cost at $64.I feel that this is an inappropriate analysis, as they are evidently looking at the cost of a visit to a urologist. Most DREs are performed by family practitioners or internists during the course of an annual physical examination. As most patients would choose to have annual physical examinations to screen for medical conditions in addition to prostate cancer, the actual cost for adding a DRE at the time of the physical examination is perhaps zero dollars. Therefore, it is inappropriate to reject the DRE because of an overestimated cost.