A rapid access diagnostic clinic for prostate cancer: the experience after one year

Background The National Cancer Control Programme is developing standards for access to diagnostics and treatment of prostate cancer. The Rapid Access Prostate Cancer (RAPC) clinic in St. James’s Hospital commenced in May 2009 allowing general practitioners (GPs) more streamlined access for patients. Aims To demonstrate that RAPC clinics allow GPs direct access to a designated cancer centre improving the prostate cancer referral process. This ultimately should reduce referral delays. Methods A prospective analysis of all patients referred to the RAPC clinic in St. James’s Hospital over a 12-month period beginning from May 2009. Results Over the 12-month period 215 patients were referred to the RAPC clinic. The median age was 63 years (range 45–78). The median waiting time between referral and review at the RAPC clinic was 13 days (range 1–37). The median PSA was 7.7 μg/L (range 2.6–150). In total 199 TRUS biopsies were performed, of which 46% were positive for prostate cancer. We found that 70% of all patients had a PSA ≤10 μg/L and of these 32% were positive for prostate cancer. For the remaining 30% of patients who had a PSA >10 μg/L, we found 63% were positive for prostate cancer. Regarding patients diagnosed with prostate cancer 56% have been referred for radiotherapy, 13% for surgery, 13% for hormonal treatment, 10% for active surveillance and 8% watchful waiting. Conclusion RAPC clinics allow GPs easier access to specialist urological opinion for patients suspected of having prostate cancer.