The best-timed pathway for suspected prostate cancer: an audit of outcomes following introduction of straight-to-mpMRI referrals
BAUS ePoster online library. Zhang Y. 11/10/20; 304246; P9-6
Mr. Yuhao Zhang
Mr. Yuhao Zhang
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The best-timed pathway for suspected prostate cancer: an audit of outcomes following introduction of straight-to-mpMRI referrals

Zhang Y1, Oliyide A1, Martin L1, Dyer J1
1Stepping Hill Hospital, Stockport, United Kingdom

Prostate cancer is the commonest male cancer in the UK, with 46,500 new cases per year and accounts for a significant economic burden for the country. The Best-Timed Pathway (BTP) was introduced by a national collaboration of urological cancer centres aiming to streamline the GP Two-Week Wait (2WW) pathway with straight-to-mpMRI testing prior to transrectal ultrasound-guided (TRUS) biopsy. This retrospective, full-cycle audit reviewed waiting times from referral to investigations and outcomes in a single tertiary urology centre in North West England. The BTP was gradually introduced during the total study period of 03/06/19 to 12/12/19 resulting in 76 patients (N0) on the old pathway and 29 patients (N1) on the BTP. Time from referral to TRUS biopsy and outcome was longer for those on the old pathway (mean 27.7 days [SD 13.0] and 43.6 days [SD 15.6], respectively) versus BTP (mean 16.5 days [SD 7.7] and 31.9 days [SD 8.9], respectively). The P-values in both instances are <0.001. Furthermore, the rate of negative biopsies increased from 25.0% under the old pathway to 51.7% under the BTP. We conclude that the BTP provides patients with a shorter wait between 2WW referral to investigations and outcomes. However, there are further improvements that can be made to the algorithm in order to reach the Faster Diagnosis Standard (FDS) target of 28 days set by NHS England. The proportional increase of negative biopsies with the BTP is a concern and needs to be scrutinised further.
The best-timed pathway for suspected prostate cancer: an audit of outcomes following introduction of straight-to-mpMRI referrals

Zhang Y1, Oliyide A1, Martin L1, Dyer J1
1Stepping Hill Hospital, Stockport, United Kingdom

Prostate cancer is the commonest male cancer in the UK, with 46,500 new cases per year and accounts for a significant economic burden for the country. The Best-Timed Pathway (BTP) was introduced by a national collaboration of urological cancer centres aiming to streamline the GP Two-Week Wait (2WW) pathway with straight-to-mpMRI testing prior to transrectal ultrasound-guided (TRUS) biopsy. This retrospective, full-cycle audit reviewed waiting times from referral to investigations and outcomes in a single tertiary urology centre in North West England. The BTP was gradually introduced during the total study period of 03/06/19 to 12/12/19 resulting in 76 patients (N0) on the old pathway and 29 patients (N1) on the BTP. Time from referral to TRUS biopsy and outcome was longer for those on the old pathway (mean 27.7 days [SD 13.0] and 43.6 days [SD 15.6], respectively) versus BTP (mean 16.5 days [SD 7.7] and 31.9 days [SD 8.9], respectively). The P-values in both instances are <0.001. Furthermore, the rate of negative biopsies increased from 25.0% under the old pathway to 51.7% under the BTP. We conclude that the BTP provides patients with a shorter wait between 2WW referral to investigations and outcomes. However, there are further improvements that can be made to the algorithm in order to reach the Faster Diagnosis Standard (FDS) target of 28 days set by NHS England. The proportional increase of negative biopsies with the BTP is a concern and needs to be scrutinised further.
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