One hundred forty-five cases in which the diagnosis was unestablished (mean age 60.1 ± 7.6 years; median 57 years, range 43–69 years) were included in a early diagnosis programme for PC. Mean time for concluding all the initial programmes till the histological diagnosis at prostate biopsy (when indicated) was 22.3 ± 5.4 days (median 21 days, range 16–32 days). Clinical characteristics and diagnostic results of this population are presented in Table 3.2 and Fig. 3.1 and compared with those of a population (Group B) submitted, in the same period and institution, to a non-MDT organised monodisciplinary urological evaluation for the early diagnosis of PC. In Group B, mean time for concluding all the initial programmes till the histological diagnosis at prostate biopsy (when indicated) was 32.7 ± 6.6 days (median 33 days, range 23–42 days).

In both services (Prostate Cancer Unit = Group A and monodisciplinary urological evaluation = Group B), diagnostic tools available to determine whether to indicate a prostate biopsy were PSA serum determination, PCA3 determination, digital rectal examination (DRE) and multiparametric MRI. In both services, a 14-core random transrectal ultrasound-guided biopsy was used and also multiparametric MRI results could be used for additional targeted samples [7].

In particular, the rate of biopsy indications and that of PC positive biopsies was 64 % and 45 %, respectively, for cases included in Group A and 52 % and 41 % for cases included in Group B. Interviewing clinicians of the Prostate Cancer Unit and those of the monodisciplinary urological service, all cases indicated for biopsy in Group B should be considered for biopsy also in Group A, whereas only 76 % of cases indicated for biopsy in Group A should be confirmed in Group B.

Table 3.3 shows the characteristics of the newly diagnosed PC obtained in the two services (Groups A and B). The distribution of the newly diagnosed PC cases in risk categories [8] is shown in Fig. 3.2. A higher percentage of cases (47.6 %) referred to our MDT were in the low-risk group.