The impact of a second confirmatory PSA before referring: a safety and cost-effective analysis.
BAUS ePoster online library. Fede Spicchiale C. 06/21/21; 318988; p1-1
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Dr. Claudia Fede Spicchiale
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Abstract
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Introduction
Our study aims to establish the safety of using a second confirmatory PSA (2PSA) before referring patients with elevated PSA (<10ng/mL) and to assess potential savings derived from it.
Patients and Methods
In a major prostate diagnostic center (PDC), referrals for the year before (Y1) and after (Y2) the introduction of a confirmatory second PSA (2PSA) prior to referral were collected. Referrals with a single abnormal PSA (1PSA) or after a 2PSA were identified. In the largest associated primary care network, the results of all PSA tests were recorded and patients with elevated PSA identified. The actions taken for these patients and outcomes were recorded. Based on standard activity numbers, a cost per assessment was established and savings derived by 2PSA estimated.
Results
351 (218 in Y1; 133 in Y2) did not fullfil the 2PSA rule and 156 (48 in Y1; 108 in Y2) did (Table1). Cancer detection rates were higher in 2PSA referrals (36% vs. 30%), and steady between Y1 and Y2 (30.5% and 33.2%), showing no statistically significant difference. In Y2, due to the 2PSA rule, 89 patients were rejected; of those, 28% were not re-referred (Figure1).Using average investigation costs per patient, the estimated savings across of a population of 550,000 could have been £ 315,530 per year.
Conclusions
The use of 2PSA rule before a referral did not have a significant impact on CaP detection. The use of the 2PSA rule as referral criteria appears safe and should be considered as it allows significant economic savings.
Our study aims to establish the safety of using a second confirmatory PSA (2PSA) before referring patients with elevated PSA (<10ng/mL) and to assess potential savings derived from it.
Patients and Methods
In a major prostate diagnostic center (PDC), referrals for the year before (Y1) and after (Y2) the introduction of a confirmatory second PSA (2PSA) prior to referral were collected. Referrals with a single abnormal PSA (1PSA) or after a 2PSA were identified. In the largest associated primary care network, the results of all PSA tests were recorded and patients with elevated PSA identified. The actions taken for these patients and outcomes were recorded. Based on standard activity numbers, a cost per assessment was established and savings derived by 2PSA estimated.
Results
351 (218 in Y1; 133 in Y2) did not fullfil the 2PSA rule and 156 (48 in Y1; 108 in Y2) did (Table1). Cancer detection rates were higher in 2PSA referrals (36% vs. 30%), and steady between Y1 and Y2 (30.5% and 33.2%), showing no statistically significant difference. In Y2, due to the 2PSA rule, 89 patients were rejected; of those, 28% were not re-referred (Figure1).Using average investigation costs per patient, the estimated savings across of a population of 550,000 could have been £ 315,530 per year.
Conclusions
The use of 2PSA rule before a referral did not have a significant impact on CaP detection. The use of the 2PSA rule as referral criteria appears safe and should be considered as it allows significant economic savings.
Introduction
Our study aims to establish the safety of using a second confirmatory PSA (2PSA) before referring patients with elevated PSA (<10ng/mL) and to assess potential savings derived from it.
Patients and Methods
In a major prostate diagnostic center (PDC), referrals for the year before (Y1) and after (Y2) the introduction of a confirmatory second PSA (2PSA) prior to referral were collected. Referrals with a single abnormal PSA (1PSA) or after a 2PSA were identified. In the largest associated primary care network, the results of all PSA tests were recorded and patients with elevated PSA identified. The actions taken for these patients and outcomes were recorded. Based on standard activity numbers, a cost per assessment was established and savings derived by 2PSA estimated.
Results
351 (218 in Y1; 133 in Y2) did not fullfil the 2PSA rule and 156 (48 in Y1; 108 in Y2) did (Table1). Cancer detection rates were higher in 2PSA referrals (36% vs. 30%), and steady between Y1 and Y2 (30.5% and 33.2%), showing no statistically significant difference. In Y2, due to the 2PSA rule, 89 patients were rejected; of those, 28% were not re-referred (Figure1).Using average investigation costs per patient, the estimated savings across of a population of 550,000 could have been £ 315,530 per year.
Conclusions
The use of 2PSA rule before a referral did not have a significant impact on CaP detection. The use of the 2PSA rule as referral criteria appears safe and should be considered as it allows significant economic savings.
Our study aims to establish the safety of using a second confirmatory PSA (2PSA) before referring patients with elevated PSA (<10ng/mL) and to assess potential savings derived from it.
Patients and Methods
In a major prostate diagnostic center (PDC), referrals for the year before (Y1) and after (Y2) the introduction of a confirmatory second PSA (2PSA) prior to referral were collected. Referrals with a single abnormal PSA (1PSA) or after a 2PSA were identified. In the largest associated primary care network, the results of all PSA tests were recorded and patients with elevated PSA identified. The actions taken for these patients and outcomes were recorded. Based on standard activity numbers, a cost per assessment was established and savings derived by 2PSA estimated.
Results
351 (218 in Y1; 133 in Y2) did not fullfil the 2PSA rule and 156 (48 in Y1; 108 in Y2) did (Table1). Cancer detection rates were higher in 2PSA referrals (36% vs. 30%), and steady between Y1 and Y2 (30.5% and 33.2%), showing no statistically significant difference. In Y2, due to the 2PSA rule, 89 patients were rejected; of those, 28% were not re-referred (Figure1).Using average investigation costs per patient, the estimated savings across of a population of 550,000 could have been £ 315,530 per year.
Conclusions
The use of 2PSA rule before a referral did not have a significant impact on CaP detection. The use of the 2PSA rule as referral criteria appears safe and should be considered as it allows significant economic savings.
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