Prostad: The development and evaluation of a prostate cancer rapid diagnostic pathway, a protocol

BackgroundDelay to cancer diagnosis is associated with poorer outcomes. In response to delays to cancer diagnosis in the UK, a number of Rapid Diagnosis Centres (RDCs), Multi-Disciplinary Centres (MDCs) and other pathway reforms have been piloted and implemented in recent years. Prostate cancer is the most commonly diagnosed cancer for men or those assigned male at birth in the UK. In Wales, the recommended time to diagnosis is within 62 days from point of suspicion. For patients served by Hywel Dda University Health Board, current waiting times on the prostate cancer diagnostic pathway are prolonged, falling well outside the 28-day decision to treat and 62-day referral to treatment targets. A revised prostate cancer diagnostic pathway called Prostad (Wesh for "prostate") has been developed and is currently being implemented with the aim of reducing time to diagnosis (or discharge) for patients referred for investigation. This protocol describes Prostad and the planned evaluation approach. MethodsThis is a mixed-method evaluation. It is shaped by patient and public involvement throughout and incorporates realist interviews with multiple stakeholders (including NHS staff and patients), process mapping, economic evaluation, and monitoring of the intervention against its aims using routinely collected data. DiscussionTo the authors knowledge, this is the first project of its kind to combine service aims evaluation, cost-effectiveness analysis and realist evaluation approaches, and as such promises findings applicable to organisations and individuals with regard to various aims and priorities. Continued patient and public involvement throughout the study constitutes one of its strengths.