The critical role of patient follow-up after receiving a diagnosis of prostatic intraepithelial neoplasia

With the increasing incidence of prostatic intraepithelial neoplasia being found at the time of prostate biopsy and the association of prostatic intra epithelial neoplasia to coexisting prostate cancer and/or the future develo pment of prostate canter, patient compliance in following post-biopsy follo w-up instructions for re-biopsy is becoming more significant in the detecti on of prostate cancer at an earlier and, therefore, potentially curable sta ge. During a 3-y period, we reviewed the charts of 130 patients who receive d an initial diagnosis of prostatic intraepithelial neoplasia after undergo ing transrectal ultrasound of the prostate with biopsy. It is our policy to inform the patient of their diagnosis of prostatic intraepithelial neoplas ia at the time of the initial biopsy and to recommend a repeat biopsy in 6- 12 months. Patients are informed of the diagnosis of prostatic intraepithel ial neoplasia verbally and in writing. In addition, a letter is sent to the ir referring physician with the re-biopsy recommendation. Thirty-nine of 13 0 patients (30%) were seen for re-biopsy within the specified time. An addi tional 36 patients (27.69%) were re-biopsied between 12 and 18 months after the initial diagnosis of prostatic intraepithelial neoplasia. An additiona l 11 patients (7%) were re-biopsied more than 18 months after their initial diagnosis. Forty-four patients failed to return for re-biopsy. Overall, pa tient follow-up within the desired protocol was poor and must be improved u pon to prevent any delays in the diagnosis of prostate cancer.