{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:30:36Z","timestamp":1789648236737,"version":"4.0.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate whether nurse navigator\u2010led triaging of high\u2010risk patients may reduce prostate cancer (PCa) diagnosis and treatment times using an in\u2010house bespoke PRostate cancer diAGnosis and MAnagement Triage In the Clinial care pathway (PRAGMATIC) triaging system, as locally advanced\/metastatic disease should be diagnosed and treated rapidly, and UK targets allow 28\u2009days for diagnosis, and 62\u2009days to commence treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We reviewed diagnosis and treatment timelines for patients undergoing 28\/62\u2010day investigation for suspected PCa at a tertiary unit in a 3\u2010month period (2022). We then introduced nurse navigator\u2010led triaging of urgent referrals and evaluated a subsequent 3\u2010month period (2024), with streamlining for rapid investigation and treatment based on prostate\u2010specific antigen, magnetic resonance imaging (MRI) staging, and histology. We hypothesised nurse navigator\u2010led triaging would improve investigation and treatment times for high\u2010risk localised, or locally advanced, or metastatic PCa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 165 and 327 consecutive patients were on the 28\/62\u2010day PCa pathway in the pre\u2010 (2022) and post\u2010nurse navigator\u2010led (2024) triaging periods, respectively. The median time from referral to first appointment (8 vs 4\u2009days), MRI (12 vs 6\u2009days), MRI result (26 vs 17\u2009days), biopsy decision (25 vs 16\u2009days), biopsy procedure (48 vs 22\u2009days), biopsy result communication (64 vs 44\u2009fays), and prostate\u2010specific membrane antigen positron emission tomography computed tomography staging scan (87 vs 56\u2009days) was reduced following nurse navigator triaging of high\u2010risk cases (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The median time from referral to treatment for Gleason Grade Group \u22653, or T3, or \u2265N1, or \u2265M1 disease (104 vs 70\u2009days; 49\/75 [65.3%] vs 72\/128 [56.3%] patients), and for M1b disease (47 vs 27\u2009days; 15\/75 [20%] vs 32\/128 [25%] patients), was reduced (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nurse navigator\u2010led triaging and stratification of the most clinically urgent suspected PCa cases was associated with improved imaging, biopsy diagnosis, and treatment times for the highest\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70191","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:39:28Z","timestamp":1773013168000},"page":"849-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>The PRAGMATIC<\/scp>\n                    pathway \u2010\n                    <scp>PRostate<\/scp>\n                    cancer diAGnosis and MAnagement Triage In Clinical care"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3396-5937","authenticated-orcid":false,"given":"Abhishek","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"},{"name":"Department of Urology NHS Lothian, Western General Hospital  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Kanabar","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Soanes","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Sathanapally","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rincy","family":"John","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling","family":"Brassill","sequence":"additional","affiliation":[{"name":"Quality Improvement Team Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryony","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Sinha","sequence":"additional","affiliation":[{"name":"Oxford Transplant Centre Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Flaxman","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"von Hasseln","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Camilleri","sequence":"additional","affiliation":[{"name":"Department of Oncology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Department of Oncology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Charlton","sequence":"additional","affiliation":[{"name":"Department of Oncology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Oncology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tuthill","sequence":"additional","affiliation":[{"name":"Oxford Transplant Centre Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Protheroe","sequence":"additional","affiliation":[{"name":"Department of Oncology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair D.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"},{"name":"Nuffield Department of Surgical Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Leslie","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Leiblich","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6498-2635","authenticated-orcid":false,"given":"Francisco","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Verrill","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergus","family":"Gleeson","sequence":"additional","affiliation":[{"name":"Department of Radiology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"MacPherson","sequence":"additional","affiliation":[{"name":"Department of Radiology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddie C.","family":"Hamdy","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"},{"name":"Nuffield Department of Surgical Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-9251","authenticated-orcid":false,"given":"Richard J.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Department of Urology Oxford University Hospitals NHS Foundation Trust, Churchill Hospital  Oxford UK"},{"name":"Nuffield Department of Surgical Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Prostate Cancer Statistics Cancer Research UK. Available at:https:\/\/www.cancerresearchuk.org\/health\u2010professional\/cancer\u2010statistics\/statistics\u2010by\u2010cancer\u2010type\/prostate\u2010cancer. Accessed October 2025"},{"key":"e_1_2_7_3_1","unstructured":"National Prostate Cancer Audit. Available at:https:\/\/www.npca.org.uk\/content\/uploads\/2024\/01\/NPCA\u2010SotN\u2010infographic.pdf. Accessed October 2025"},{"key":"e_1_2_7_4_1","volume-title":"The NHS Cancer Plan","author":"Department of Health","year":"2000"},{"key":"e_1_2_7_5_1","unstructured":"NHS England.The NHS Long Term Plan.2019https:\/\/www.longtermplan.nhs.uk\/"},{"key":"e_1_2_7_6_1","unstructured":"GIRFT Urology: Towards Better Diagnosis and Management of Suspected Prostate Cancer.2024Available at:https:\/\/gettingitrightfirsttime.co.uk\/wp\u2010content\/uploads\/2024\/04\/GIRFT\u2010Urology\u2010Towards\u2010Better\u2010Diagnosis\u2010Management\u2010of\u2010Suspected\u2010Prostate\u2010Cancer\u2010FINAL\u2010V1\u2010April\u20102024\u20101.pdf. Accessed October 2025"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-023-02308-9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801993"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.042"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15277"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000678"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00100-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30314-7"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214122"},{"key":"e_1_2_7_15_1","unstructured":"BAUS British Association of Urological Surgeons.COVID\u201019 strategy for the Interim management of prostate cancer prepared by the BAUS Section of Oncology. Version 1: 19 March 2020.cmcanceralliance.nhs.uk"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15899"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15971"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02774-y"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16845"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70191","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70191","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T08:00:46Z","timestamp":1776067246000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/bju.70191"],"URL":"https:\/\/doi.org\/10.1111\/bju.70191","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"2026-02-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}