https://doi.org/10.4081/aiua.2021.4.389

Diagnostic assessment program for prostate cancer: Lessons learned after 2 years and degree of compliance to Canadian guidelines

Vol. 93 No. 4 (2021)
Submitted: September 21, 2021
Accepted: October 17, 2021
Published: December 20, 2021
Prostate cancer, Diagnostic assessment program, Prostate biopsy
Abstract Views: 1371
PDF: 388
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Authors

Waleed Shabana
waleed.shabana@gmail.com
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Ahmed Kotb
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Daniel Tesolin
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Mohammed F.K. Ibrahim
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Kristi Dolcetti
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Amy Boucher
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Mohammed Bassuony
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Kevin Ramchandar
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Ahmed S. Zakaria
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Hazem Elmansy
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Walid Shahrour
Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.

Background: In 2018, our Institute launched the Diagnostic Assessment Program (DAP) for prostate cancer. It enabled quick access to a urologist for patients presented to family physician with elevated PSA and allowed fast multidisciplinary patient care. We aim to document our data over 2 years in comparison to data before implementation of DAP and its impact on the degree of adherence to Canadian guidelines.
Methods: From April 2016 to April 2020, 880 patients who were evaluated for prostate cancer at Thunder Bay Regional Health Sciences Centre (TBRHSC) were included in this study. Patients’ characteristics, clinical data, waiting times and line of treatment before and after implementation of DAP were calculated and statistically analysed.
Results: The median waiting time to urology consultation was significantly reduced from 68 (IQR 27-168) days to 34 (23-44) days (p < 0.001). The time from patient’s referral to prostate biopsy decreased substantially from 34 (20-66) days to 18(11- 25) days after DAP (p < 0.001). After DAP, the percentage of Gleason 6 detected prostate cancers were significantly increased (19.7% to 30%) (p = 0.02). After DAP, rate for intermediate-risk patients elected for external beam radiotherapy (from 53.5% to 57.9%, p = 0.53) and radical prostatectomy (from 34.5% to 39.4%, p = 0.47) increased. More compliance to Canadian guidelines was observed in intermediate risk patients (88% vs 97.3%, p =.008).
Conclusions: Implementation of DAP has led to a notable reduction of waiting time to urology consult and prostate biopsy. There is significant increase in Gleason 6 detected prostate cancer. Increased compliance to Canadian guidelines was detected in intermediate risk patients.

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How to Cite

Shabana, W. ., Kotb, A., Tesolin, D., Ibrahim, M. F., Dolcetti, K., Boucher, A., Bassuony, M., Ramchandar, K., Zakaria, A. S., Elmansy, H., & Shahrour, W. (2021). Diagnostic assessment program for prostate cancer: Lessons learned after 2 years and degree of compliance to Canadian guidelines. Archivio Italiano Di Urologia E Andrologia, 93(4), 389–392. https://doi.org/10.4081/aiua.2021.4.389

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