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A ‘One Stop’ P rostate C linic for rural and remote men: a report on the first 200 patients
Author(s) -
McCombie Steve P.,
Hawks Cynthia,
Emery Jon D.,
Hayne Dickon
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13100
Subject(s) - medicine , prostate cancer , referral , rectal examination , tertiary referral centre , cohort , prostatectomy , prospective cohort study , prostate specific antigen , urology , urinary system , prostate , cancer , family medicine
Objective To report on the structure and outcomes of a new ‘ O ne S top’ P rostate C linic ( OSPC ) designed specifically for rural and remote men. Patients and Methods Prospective cohort study of the first 200 rural or remote men to access a new OSPC at a public tertiary‐level hospital in W estern A ustralia between A ugust 2011 and A ugust 2014. Men attended for urological assessment, and proceeded to same‐day transrectal ultrasonography‐guided prostate biopsies, if appropriate. Referral criteria were either two abnormal age‐related prostate‐specific antigen ( PSA ) levels in the absence of urinary tract infection (UTI), or an abnormal digital rectal examination ( DRE ) regardless of PSA level. Results The median (range) distance travelled was 1545 (56–3229) km and median (range) time from referral to assessment was 33 (2–165) days. The median (range) age was 62 (38–85) years, PSA level was 6.7 (0.5–360) ng/mL and 39% (78/200) had a suspicious DRE . In all, 92% (184/200) of men proceeded to prostate biopsies, and 60% (111/184) of these men were diagnosed with prostate cancer. Our complication rate was 3.5% (6/172). Radical prostatectomy (46/111), active surveillance (28/111) and external beam radiation therapy (26/111) were the commonest subsequent treatment methods. A $1045 (Australian dollars) cost‐saving per person was estimated based on the reduced need for travel with the OSPC model. Conclusion The OSPC is an effective and efficient model for assessing men suspected of having prostate cancer living in rural and remote areas of W estern A ustralia, and this model may be applicable to other areas.