Five-year outcomes of suspected prostate cancer referrals seen in a nurse led clinic
BAUS ePoster online library. Waymont C. 11/10/20; 304168; P11-3
Clare Waymont
Clare Waymont
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Five-year outcomes of suspected prostate cancer referrals seen in a nurse led clinic

Waymont C1, Kusinski K1, Akins J1, During V1, Mak D1, Cooke P1

1New Cross Hospital, Wolverhampton, United Kingdom

Introduction and Objectives: Implementation of best practice pathways for suspected prostate cancer is a challenge for NHS Trusts. Locally, suspected prostate cancer referrals rose by 39% from 2014 to 2018. Streamlining of services is essential to achieve diagnostic targets. An analysis of the feasibility of discharging patients with a normal age-related PSA measurement on repeat testing or an MRI reported as PI-RADS ≤2 (P≤2) was performed.

Methods:
A retrospective audit of patients seen in the Advanced Nurse Practitioner led suspected prostate cancer clinic over a five-year period was undertaken. Patients with no history of prostate cancer and who did not undergo prostate biopsy at first referral were included in audit analysis.

Results:
Between 2014-2019, 2393 patients were seen in the nurse led clinic. 953 patients fulfilled the audit inclusion criteria. 361 (37.8%) patients were discharged to primary care. 272 (28.5%) patients had a normal age-related PSA on repeat testing. 6 (1.6%) of the discharged patients were subsequently found to have a clinically significant prostate cancer (Gleason ≥3+4). Mean re-referral time of 22 months. 96 (10%) patients were discharged without biopsy following an MRI P≤2 and no cancer has subsequently been found to date. 90 patients discharged to primary care with specific advice for PSA follow up had no subsequent PSA testing.

Conclusion:
Adopting referral criteria of two raised PSA blood tests and discharging patients with MRI P≤2 may help achieve best practice pathway targets, whilst minimising risk of missing clinically significant prostate cancer.
Five-year outcomes of suspected prostate cancer referrals seen in a nurse led clinic

Waymont C1, Kusinski K1, Akins J1, During V1, Mak D1, Cooke P1

1New Cross Hospital, Wolverhampton, United Kingdom

Introduction and Objectives: Implementation of best practice pathways for suspected prostate cancer is a challenge for NHS Trusts. Locally, suspected prostate cancer referrals rose by 39% from 2014 to 2018. Streamlining of services is essential to achieve diagnostic targets. An analysis of the feasibility of discharging patients with a normal age-related PSA measurement on repeat testing or an MRI reported as PI-RADS ≤2 (P≤2) was performed.

Methods:
A retrospective audit of patients seen in the Advanced Nurse Practitioner led suspected prostate cancer clinic over a five-year period was undertaken. Patients with no history of prostate cancer and who did not undergo prostate biopsy at first referral were included in audit analysis.

Results:
Between 2014-2019, 2393 patients were seen in the nurse led clinic. 953 patients fulfilled the audit inclusion criteria. 361 (37.8%) patients were discharged to primary care. 272 (28.5%) patients had a normal age-related PSA on repeat testing. 6 (1.6%) of the discharged patients were subsequently found to have a clinically significant prostate cancer (Gleason ≥3+4). Mean re-referral time of 22 months. 96 (10%) patients were discharged without biopsy following an MRI P≤2 and no cancer has subsequently been found to date. 90 patients discharged to primary care with specific advice for PSA follow up had no subsequent PSA testing.

Conclusion:
Adopting referral criteria of two raised PSA blood tests and discharging patients with MRI P≤2 may help achieve best practice pathway targets, whilst minimising risk of missing clinically significant prostate cancer.
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