Department of Urology, St. James's Hospital, Dublin 8, Ireland.
Ir J Med Sci. 2011 Jun;180(2):505-8. doi: 10.1007/s11845-011-0695-3. Epub 2011 Feb 4.
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.
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.
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.
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.
RAPC clinics allow GPs easier access to specialist urological opinion for patients suspected of having prostate cancer.
国家癌症控制计划正在制定前列腺癌诊断和治疗的准入标准。圣詹姆斯医院的快速通道前列腺癌(RAPC)诊所于 2009 年 5 月开始运作,使全科医生(GP)能够更顺利地为患者提供服务。
证明 RAPC 诊所允许 GP 直接进入指定的癌症中心,从而改善前列腺癌转诊流程。这最终应该会减少转诊延误。
对 2009 年 5 月开始的 12 个月期间转诊到圣詹姆斯医院 RAPC 诊所的所有患者进行前瞻性分析。
在 12 个月期间,有 215 名患者被转诊到 RAPC 诊所。中位年龄为 63 岁(范围 45-78 岁)。从转诊到 RAPC 诊所就诊的中位等待时间为 13 天(范围 1-37 天)。中位 PSA 为 7.7μg/L(范围 2.6-150μg/L)。总共进行了 199 次经直肠超声引导下前列腺活检,其中 46%为前列腺癌阳性。我们发现,所有患者中有 70%的 PSA ≤ 10μg/L,其中 32%为前列腺癌阳性。对于 PSA > 10μg/L 的其余 30%的患者,我们发现 63%为前列腺癌阳性。对于被诊断为前列腺癌的患者,56%已被转介接受放疗,13%接受手术治疗,13%接受激素治疗,10%接受主动监测,8%接受观察等待。
RAPC 诊所使 GP 更容易获得泌尿科专家的意见,以评估疑似患有前列腺癌的患者。