Delays in prostate cancer care within a hospital network in Victoria, Australia

• Published in: ANZ journal of surgery 2019-12, Vol.89 (12), p.1599-1604
• Main Authors: Qu, Liang G., Nzenza, Tatenda, McMillan, Kevin, Sengupta, Shomik
• Format: Article
• Language: English
• Subjects: Antigens; Biopsy; Demographics; Demography; diagnostic delay; early detection; Genetics; Health risks; Intervals; Medical treatment; Patients; Prostate cancer; PSA testing; Risk assessment; Urology
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.15554

Background To characterize and identify interval delays for patients referred to a tertiary hospital with prostate‐specific antigen (PSA) elevation, as delays in prostate cancer diagnosis may result in worse outcomes. Patients and methods We retrospectively reviewed consecutive referrals to our urology unit for abnormal PSA assessments, over a 24‐month period. Demographics, PSA measurements, clinical staging, biopsy grade and treatment were recorded. Referral, review, biopsy and treatment intervals were calculated. Associations were analysed using Wilcoxon rank‐sum tests. Results Two hundred and thirty men were included, with median age 65 years and PSA 7.6 ng/mL at referral, of whom 197 (85.7%) men had cancer on biopsy. The median referral, review, biopsy and treatment intervals were 8.1 (range 0.1–109.9), 1.7 (0.1–19.4), 1.9 (0.0–31.5) and 1.9 (0.2–17.3) months respectively. One hundred and seven patients (56.6%) had more than one abnormal PSA prior to referral. Eighty‐five (60.7%) patients had referral delay ≥3 months, and were found to be: older (66 versus 63 years, P = 0.02), less likely to have family history (12 versus 24%, P = 0.07) and have a prior abnormal PSA (93 versus 0%, P