[The diagnostic situation with prostatic cancer in primary care].
OBJECTIVE
To evaluate the quality of diagnosis in primary care (PC) of prostate cancer (CP) and to analyse the factors linked to late diagnosis.


METHODS
Retrospective, cross-sectional study.


METHODS
Five PC centres and a hospital (covering about 130,000 inhabitants).


METHODS
All CP diagnosed in PC between April 1989 and October 1996.


RESULTS
PC clinical history, hospital records and request for specialist consultation in 41 cases were reviewed. In cases coming from PC (71%), the most frequent clinical picture was mixed prostate syndrome (44.8%). PSA (20.7%) and urine sediment (17.2%) were the most commonly requested investigations. Rectal touch (RT) occurred in one case (3.4%) and four cases were diagnosed as CP. In the urology service, RT occurred in 68% of cases, with PSA determined in 59% of those who had not had it. After the first visit, 44% were diagnosed as CP. Two time intervals in common between PC and hospital were studied: referral-specialist visit and specialist visit-diagnosis. In PC there were mean delays of 50 days (SD, 53; percentile [P] 25 = 14; P50 = 35; P75 = 75) and 420 days (SD, 595; P25 = 72; P50 = 194; P75 = 490), respectively. In the hospital the times were 6 days for the first (SD, 6; P25 = 2; P50 = 5; P75 = 8.5), and 168 for the second (SD, 176; P25 = 34; P50 = 130; P75 = 271). The differences were statistically significant: p = 0.0006 and p = 0.05.


CONCLUSIONS
Doing RT and PSA determination in primary care would favour diagnosis in the cases of CP. The creation of training programmes and rapid referral routes to hospital could reduce the delays looked at.
Pérez Cano
E
E
Area Básica de Salud Viladecans II, Hospital de Viladecans y DAP Baix Llobregat, Barcelona.
Simonet Aineto
P J
PJ
Vargas Blasco
C
C
Castells Esteve
M
M
Parellada Esquius
N
N
D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain; D018709:Statistics, Nonparametric