Meeting the 28-day faster diagnosis standard - Rapid Access Prostate Imaging and Diagnosis (RAPID) compared to a standard pathway
BAUS ePoster online library. Keskin S. 11/10/20; 304182; P11-2 Disclosure(s): None
Dr. Sarp Keskin
Dr. Sarp Keskin
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Meeting the 28-day faster diagnosis standard - Rapid Access Prostate Imaging and Diagnosis (RAPID) compared to a standard pathway

Keskin S2, Eldred-Evans D1, Bertoncelli Tanaka M2, Maynard W2, Bass E1, Connor M1, Reddy D1, Hosking-Jervis F1, Bhola-Stewart H2, Powell L3, Natarajan M3, Sri D3, Ahmad S4, Joshi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Qazi H3, Gordon S4, Ahmed H1
1Imperial College London, United Kingdom, 2Imperial College NHS Trust, London, United Kingdom, 3St George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospitals, London, United Kingdom, 5RM Partners: West London Cancer Alliance, London, United Kingdom, 6Sunderland Royal Hospital, United Kingdom

Introduction and Objective: The new 28-day Faster Diagnosis Standard (FSD) may present a challenge for prostate cancer. We compare the outcomes of Rapid Access Prostate Imaging and Diagnosis (RAPID) pathway to a standard pathway.

Methods:
RAPID included 994 men with 267 in the standard pathway (04/2017-12/2019). Men referred into the RAPID pathway were booked for a mpMRI followed by a consultation on the same day. A transperineal prostate biopsy (TP-Bx) was offered if the MRI score was 4 or 5, or a score of 3 with PSA‐density >/=0.12, usually on the same day. Men not suitable for RAPID followed a standard pathway with a consultation first. Comparisons were made with Mann-Whitney U Tests.

Results:
Median age was 66 years [IQR 60‐72] and PSA 7 [IQR 0.1-286] in RAPID compared to 80 years [IQR 39-98] and PSA 9.2 [IQR 0.3-4730] for the standard pathway with 100% (994/994) and 60% (161/267) having a mpMRI. The median time from referral to mpMRI was significantly shorter for RAPID; 10 days (IQR 7-13) vs. 42 days (IQR 10-403) (p=0.02). In RAPID, 42.2% (420/994) had a non-suspicious mpMRI and did not require TP-Bx; of those having an mpMRI in the standard pathway 54.6% (88/161) had TP-Bx with 45% (40/88) having biopsy without mpMRI due to high clinical suspicion (total 32.9% (88/267) had TP-Bx).

Conclusions:
The RAPID pathway provides a fast-access, streamlined approach to meet the new 28-day faster cancer diagnosis national target.
Meeting the 28-day faster diagnosis standard - Rapid Access Prostate Imaging and Diagnosis (RAPID) compared to a standard pathway

Keskin S2, Eldred-Evans D1, Bertoncelli Tanaka M2, Maynard W2, Bass E1, Connor M1, Reddy D1, Hosking-Jervis F1, Bhola-Stewart H2, Powell L3, Natarajan M3, Sri D3, Ahmad S4, Joshi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Qazi H3, Gordon S4, Ahmed H1
1Imperial College London, United Kingdom, 2Imperial College NHS Trust, London, United Kingdom, 3St George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospitals, London, United Kingdom, 5RM Partners: West London Cancer Alliance, London, United Kingdom, 6Sunderland Royal Hospital, United Kingdom

Introduction and Objective: The new 28-day Faster Diagnosis Standard (FSD) may present a challenge for prostate cancer. We compare the outcomes of Rapid Access Prostate Imaging and Diagnosis (RAPID) pathway to a standard pathway.

Methods:
RAPID included 994 men with 267 in the standard pathway (04/2017-12/2019). Men referred into the RAPID pathway were booked for a mpMRI followed by a consultation on the same day. A transperineal prostate biopsy (TP-Bx) was offered if the MRI score was 4 or 5, or a score of 3 with PSA‐density >/=0.12, usually on the same day. Men not suitable for RAPID followed a standard pathway with a consultation first. Comparisons were made with Mann-Whitney U Tests.

Results:
Median age was 66 years [IQR 60‐72] and PSA 7 [IQR 0.1-286] in RAPID compared to 80 years [IQR 39-98] and PSA 9.2 [IQR 0.3-4730] for the standard pathway with 100% (994/994) and 60% (161/267) having a mpMRI. The median time from referral to mpMRI was significantly shorter for RAPID; 10 days (IQR 7-13) vs. 42 days (IQR 10-403) (p=0.02). In RAPID, 42.2% (420/994) had a non-suspicious mpMRI and did not require TP-Bx; of those having an mpMRI in the standard pathway 54.6% (88/161) had TP-Bx with 45% (40/88) having biopsy without mpMRI due to high clinical suspicion (total 32.9% (88/267) had TP-Bx).

Conclusions:
The RAPID pathway provides a fast-access, streamlined approach to meet the new 28-day faster cancer diagnosis national target.
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