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Irish Journal of Medical Science

, Volume 183, Issue 2, pp 173–179 | Cite as

Audit of rapid access introduction reveals high prevalence of prostate cancer in Western Region

  • E. M. BoltonEmail author
  • B. D. Kelly
  • M. R. Quinlan
  • F. T. D’Arcy
  • M. Azar
  • C. M. Dowling
  • M. Power
  • P. McCarthy
  • C. Roche
  • K. Walsh
  • E. Rogers
  • G. C. Durkan
Original Article

Abstract

Introduction

Men with symptoms suggestive of prostate cancer are now directly referred by their general practitioners to rapid access prostate assessment clinics (RAPACs). This service implements recommendations outlined by the National Cancer Control Programme. The RAPAC was introduced at Galway University Hospital, Galway, Ireland in June 2009, aiming to structure GP referral of patients with suspected prostate cancer to a urology service.

Aims

The aims of this study are to assess our initial experience with particular emphasis on access times, patient demographics, detection rates and treatment outcomes.

Methods

Data on all patients presenting to the RAPAC during the preliminary 2-year period have been gathered prospectively and analysed using standard parametric analysis methods.

Results

A total of 1,106 patients were reviewed at 278 clinic sessions during the initial 2-year period. The average waiting time to first clinic visit was 18 days (12–39 days). The mean age of referral to the clinic is 65 years (44–88 years). The mean PSA is 16.31 g/dL (0.4–845 g/dL). Of the 1106 patients undergoing TRUS biopsies, 503 (45.5 %) patients were diagnosed with prostate cancer. Further analysis patient demographics and cancer grading is presented in the article. Seventy-one patients (14.1 %) underwent radical retropubic prostatectomy. Sixty-seven patients (13.3 %) are being followed on an active monitoring programme, whilst 235 (56.7 %) received primary treatment with external beam radiotherapy and 68 (13.5 %) received brachytherapy.

Conclusion

This data highlight the necessity of a RAPAC to streamline the provision of prostate cancer services in the west of Ireland.

Keywords

Prostate cancer Rapid access clinics PSA Digital rectal examination 

Notes

Conflicts of interest

None to declare.

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Copyright information

© Royal Academy of Medicine in Ireland 2013

Authors and Affiliations

  • E. M. Bolton
    • 1
    Email author
  • B. D. Kelly
    • 1
  • M. R. Quinlan
    • 1
  • F. T. D’Arcy
    • 1
  • M. Azar
    • 1
  • C. M. Dowling
    • 1
  • M. Power
    • 1
  • P. McCarthy
    • 2
  • C. Roche
    • 2
  • K. Walsh
    • 1
  • E. Rogers
    • 1
  • G. C. Durkan
    • 1
  1. 1.Department of UrologyGalway University HospitalGalwayIreland
  2. 2.Department of RadiologyGalway University HospitalGalwayIreland

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