Regional cooperation critical pathway for patients with suspicious prostate cancer with elevated PSA

• Published in: The Journal of Japan Society for Health Care Management Vol. 8; no. 2; pp. 381 - 385
• Main Authors: Kato, Tomonori, Kitoh, Hiroki, Akakura, Koichiro, Nakamura, Takeshi, Mizoguchi, Kenichi, Nakajima, Toshihiko, Matsuzaki, Kanako
• Format: Journal Article
• Language: Japanese
• Published: Japan Society for Health Care Management 01.09.2007
• Subjects: prostate cancer; prostate specific antigen (PSA); regional cooperation critical pathway
• ISSN: 1881-2503; 1884-6807
• DOI: 10.11191/jhm2006.8.381

To accomplish an effective and appropriate follow-up of patients with elevated level of serum prostate specific antigen (PSA) and negative test for prostate biopsy, a critical pathway has been proposed based on the regional healthcare network between urologists and primary care physicians. A questionnaire on the management of urological diseases including prostate cancer was sent to 48 primary care physicians in Ushigome Area, Shinjuku -ku, Tokyo. As a consequence of the analysis of the answers and discussion between urologists and primary care physicians, a regional cooperation critical pathway was prepared for patients with suspicious prostate cancer. Of 28 responders, 23 (82%) agreed to survey their patients with suspicious prostate cancer by measuring serum PSA level. Thus, a regional cooperation critical pathway was introduced, including screening of PSA during the primary care physician's urological examinations and, if required, prostate biopsy at a referred urologist, in case of negative test for biopsy, followed by a follow-up with serial PSA measurements at the primary care physician. When retuning to the primary care physician, interval of PSA measurements and criteria for re-referring to yet another urologist were indicated for each case by the urologist. In conclusion, a regional cooperation critical pathway for patients of suspicious prostate cancer established a regional partnership between primary care physicians and urologists thus enabling to offer appropriate care to patients with suspicious prostate cancer.