title: Audit of rapid access introduction reveals high prevalence of prostate cancer in Western Region.
abstract: BACKGROUND
  Men with symptoms suggestive of prostate cancer are now directly referred by their general practitioners to rapid access prostate assessment clinics (RAPACs). This service implements recommendations outlined by the National Cancer Control Programme. The RAPAC was introduced at Galway University Hospital, Galway, Ireland in June 2009, aiming to structure GP referral of patients with suspected prostate cancer to a urology service.
  
  
  OBJECTIVE
  The aims of this study are to assess our initial experience with particular emphasis on access times, patient demographics, detection rates and treatment outcomes.
  
  
  METHODS
  Data on all patients presenting to the RAPAC during the preliminary 2-year period have been gathered prospectively and analysed using standard parametric analysis methods.
  
  
  RESULTS
  A total of 1,106 patients were reviewed at 278 clinic sessions during the initial 2-year period. The average waiting time to first clinic visit was 18 days (12-39 days). The mean age of referral to the clinic is 65 years (44-88 years). The mean PSA is 16.31 g/dL (0.4-845 g/dL). Of the 1106 patients undergoing TRUS biopsies, 503 (45.5 %) patients were diagnosed with prostate cancer. Further analysis patient demographics and cancer grading is presented in the article. Seventy-one patients (14.1 %) underwent radical retropubic prostatectomy. Sixty-seven patients (13.3 %) are being followed on an active monitoring programme, whilst 235 (56.7 %) received primary treatment with external beam radiotherapy and 68 (13.5 %) received brachytherapy.
  
  
  CONCLUSIONS
  This data highlight the necessity of a RAPAC to streamline the provision of prostate cancer services in the west of Ireland.
authors.affiliation: Department of Urology, Galway University Hospital, Galway, Ireland, ladycloona@yahoo.ie.
authors.forename: E M
authors.initials: EM
authors.lastname: Bolton
authors.forename: B D
authors.initials: BD
authors.lastname: Kelly
authors.forename: M R
authors.initials: MR
authors.lastname: Quinlan
authors.forename: F T
authors.initials: FT
authors.lastname: D'Arcy
authors.forename: M
authors.initials: M
authors.lastname: Azar
authors.forename: C M
authors.initials: CM
authors.lastname: Dowling
authors.forename: M
authors.initials: M
authors.lastname: Power
authors.forename: P
authors.initials: P
authors.lastname: McCarthy
authors.forename: C
authors.initials: C
authors.lastname: Roche
authors.forename: K
authors.initials: K
authors.lastname: Walsh
authors.forename: E
authors.initials: E
authors.lastname: Rogers
authors.forename: G C
authors.initials: GC
authors.lastname: Durkan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D058006:General Practice; D006785:Hospitals, University; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015995:Prevalence; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D017430:Prostate-Specific Antigen