Socioeconomic differences in prostate cancer diagnosis and stage following the introduction of Rapid Access Prostate Clinics in Ireland

Background

Rapid Access Prostate Clinics (RAPCs) were introduced in Ireland in 2009 to centralise and standardise prostate cancer (PCa) diagnosis within designated cancer centres. While RAPCs aim to improve diagnostic organisation following general practitioner referral, access remains influenced by socioeconomic differences in prostate-specific antigen testing and referral patterns. We examined changes in PCa incidence and stage at diagnosis following RAPC implementation and whether trends differed across socioeconomic groups. Patients and methods: Using population-based data from the National Cancer Registry Ireland, we identified men aged 50-70 years diagnosed with PCa between 2000 and 2022. Socioeconomic status was assigned using the Pobal Haase-Pratschke Deprivation Index. Interrupted time-series analyses using negative binomial regression compared trends before (2000-2008) and after (2009-2022) RAPC implementation. Analyses were conducted by deprivation quintile and tumour stage, with sensitivity analyses restricted to cancer centres.