{"id":11700,"date":"2025-04-16T05:00:41","date_gmt":"2025-04-16T09:00:41","guid":{"rendered":"https:\/\/www.med.unc.edu\/urology\/?p=11700"},"modified":"2026-02-24T16:27:23","modified_gmt":"2026-02-24T21:27:23","slug":"unc-urologys-rapid-access-pathway-featured-at-auas-diagnostic-excellence-summit","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/urology\/unc-urologys-rapid-access-pathway-featured-at-auas-diagnostic-excellence-summit\/","title":{"rendered":"UNC Urology\u2019s Rapid Access Pathway Featured at AUA\u2019s Diagnostic Excellence Summit"},"content":{"rendered":"

At the American Urological Association\u2019s Expert Convening on Advancing Diagnostic Excellence in Prostate Cancer \u2013 Prostate MR Image Quality<\/a>, UNC Urology\u2019s Drs. Hung-Jui (Ray) Tan<\/a> and Zach Feuer<\/a> presented a powerful example of turning clinical research into meaningful patient outcomes. Their segment, titled \u201cFrom PubMed to Practice \u2013 The North Carolina Experience,\u201d highlighted the development and impact of UNC Urology\u2019s rapid access program, a coordinated, evidence-based care pathway designed to accelerate and improve the diagnosis of prostate cancer<\/p>\n

Held in October 2024, the AUA convening brought together national experts in urology, radiology, and oncology to address a critical aspect of prostate cancer care: the quality and consistency of prostate MR imaging. The UNC presentation spotlighted the department\u2019s rapid access program, a data-driven model of care that has become a benchmark for how to translate emerging evidence into real-world practice.<\/p>\n

Read the recently published meeting summary and notes<\/a><\/p>\n

Reimagining the Diagnostic Pathway for Patients with Elevated PSA<\/h2>\n

As a statewide referral center, UNC Urology routinely receives a high volume of patients with elevated PSA levels, often the first signal of potential prostate cancer. Before the launch of the rapid access program, the average wait time from referral to biopsy stretched 4\u20136 months, creating delays that were especially concerning given the documented disparities in prostate cancer incidence and outcomes.<\/p>\n

Recognizing that timely care is essential, especially for high-risk groups, Drs. Tan and Feuer led efforts to redesign the diagnostic pathway with a focus on speed, efficiency, and equity. Working with a cross-disciplinary team, they developed a three-step model centered on initial consult, prostate MRI, and biopsy, underpinned by virtual care, centralized scheduling, and evidence-based protocols.<\/p>\n

Precision Through Protocol<\/h2>\n

Key innovations of the program include:<\/p>\n

    \n
  • Telehealth appointments for initial consults and MRI review.<\/li>\n
  • A streamlined MRI acquisition process, including retrieval of outside MRIs.<\/li>\n
  • A standardized biopsy decision algorithm to guide next steps based on MRI findings and PSA density.<\/li>\n<\/ul>\n

    For example:<\/p>\n

      \n
    • Patients with PI-RADS 3\u20135 lesions proceed to MRI fusion biopsy.<\/li>\n
    • PI-RADS 1\u20132 cases are assessed further based on PSA density >0.15, Black ancestry, and patient preference.<\/li>\n<\/ul>\n

      The results have been transformative:<\/p>\n

        \n
      • Referral-to-biopsy time dropped by 70%, now averaging just 58 days.<\/li>\n
      • Using the standardized biopsy decision algorithm, prostate biopsy was avoided in nearly one-third of men referred for elevated PSA.<\/li>\n
      • Of those biopsied, 39% were diagnosed with clinically significant prostate cancer. In contrast, only 26% had a negative biopsy, serving as a major decrease from historical levels. These findings highlight the success of UNC’s risk-adapted approach, optimizing diagnostic yield while reducing the number of low-value procedures performed.<\/li>\n<\/ul>\n

        Additionally, for men with lower-risk features (e.g., PI-RADS 3 with PSA density <0.15), the detection rate for significant cancer was under 10%, suggesting future opportunities to right-size diagnostic evaluation.<\/p>\n