title: The potentially curable prostate cancer patient and the pathways leading to diagnosis and treatment.
abstract: OBJECTIVE
  Potentially curable prostate cancer is a diagnostic challenge for the general practitioner (GP). In a defined catchment area we wanted to discover why patients consulted their GPs and the reasons for their referral to the urologist.
  
  
  METHODS
  Patients remitted to our "early prostate cancer clinic" with suspected potentially curable prostate cancer between January 1997 and December 2000 were included in the study. Patient information was registered according to a prospectively designed protocol.
  
  
  RESULTS
  Of the 872 patients examined, prostate cancer was diagnosed in 41.3% (360/872). Median age was 63.1 years and median total prostate-specific antigen (PSA) level was 8.6 microg/l. The main reason for referral to a urologist was elevated PSA alone. However, the majority of the patients had no urological symptoms when they consulted their GP. As no local or national screening recommendations existed, we believe that opportunistic PSA screening has been common.
  
  
  CONCLUSIONS
  The most important reason for referring patients to our specialist clinic was elevated PSA, often detected by means of opportunistic PSA screening. This study shows the effect of PSA testing in real-life practice.
authors.affiliation: Section of Urology, Department of Surgery, The Gade Institute, Haukeland University Hospital, Bergen, Norway. peder.gjengsto@helse-bergen.no
authors.forename: Peder
authors.initials: P
authors.lastname: Gjengstø
authors.forename: Johan
authors.initials: J
authors.lastname: Eide
authors.forename: Jannicke
authors.initials: J
authors.lastname: Frugård
authors.forename: August
authors.initials: A
authors.lastname: Bakke
authors.forename: Per Age
authors.initials: PA
authors.lastname: Høisaeter
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways; D005194:Family Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway; D010173:Palpation; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012017:Referral and Consultation; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis
chemical_list: D017430:Prostate-Specific Antigen