Adherence to discharge protocols and prostate‐specific antigen surveillance plans in men without a prostate cancer diagnosis

Abstract

Prostate‐specific antigen (PSA) surveillance testing is a valuable tool in the ongoing care of men who have undergone investigations into potential prostate cancer, with a benign outcome. A literature review was conducted to assess the published evidence into discharge protocols for men who have undergone investigations into prostate cancer with benign outcomes, and compliance with, and attrition from, these protocols in this patient group. When insufficient literature was retrieved, the search was broadened to include men with low‐grade prostate cancer on active surveillance pathways. There is little evidence in the published literature surrounding the issue of compliance with discharge plans in the target group. Concordance with active surveillance plans is better documented, but evidence remains relatively scarce. Evidence from research into men with low‐grade prostate cancer shows that compliance with discharge plans is a complex issue with many factors affecting outcomes. The attitudes of physicians, along with those of patients, are a major component, as is the availability of consistent and accessible guidelines. The literature surrounding men who have had benign outcomes from investigations into potential prostate cancer tends to make little reference to the issues surrounding concordance, and it is clear that this is not a well‐researched area. Concerns were raised surrounding the finding that up to 50% of men who have not adhered to their PSA surveillance plans have had other routine bloods drawn by their general practitioners (GPs) raising the issue of GP non‐compliance. The issue of compliance with PSA surveillance plans in men without a prostate cancer diagnosis is clearly a complex one which is compounded by the lack of nationally standardized discharge protocols. Further research is required to design a standardized discharge protocol to improve compliance with surveillance pathways, thereby improving early detection of developing cancers.