Abstract:Objective To evaluate the intervention effect of collaborative follow-up management by urological specialists and health management center coordinators on individuals with prostate-specific antigen (PSA) in the gray zone undergoing physical examinations. Methods Participants who underwent physical examinations at the Health Management Center of Hangzhou Hospital of Traditional Chinese Medicine from 2022 to 2024 and had initial serum PSA levels of 4.0-10.0 ng/mL were enrolled as study subjects. Examinees with PSA in the gray zone identified from January 2022 to December 2023 were assigned to the control group and received routine management, while those identified from January to December 2024 were assigned to the intervention group and received collaborative follow-up management. Basic information, follow-up data, re-examination records and treatment outcomes were collected through the Health Management Center's examination information system, laboratory system, and follow-up registration records of the Hangzhou Hospital of Traditional Chinese Medicine. The prostate cancer-related knowledge was assessed using the Prostate Cancer Awareness Questionnaire. The follow-up accessibility, re-examination adherence, and pathological diagnosis rate of prostate cancer were compared between the two groups. The differences in prostate cancer knowledge scores between the two groups before and after intervention were compared using repeated-measures analysis of variance. Results There were 2 188 participants in the control group and 1 294 participants in the intervention group. No significant differences were found between the two groups in marital status, smoking, hypertension, diabetes mellitus, benign prostatic hyperplasia, chronic prostatitis, family history of prostate cancer and initial PSA level (all P>0.05). The follow-up accessibility and re-examination adherence in the intervention group were higher than in the control group (96.68% vs. 88.03%, 91.19% vs. 37.52%, both P<0.05). The acquisition rate of traceable treatment outcome records and pathological diagnosis rate of prostate cancer were higher than in the control group (89.88% vs. 35.37%, 12.21% vs. 9.04%, both P<0.05). Repeated-measures analysis of variance revealed a significant interaction effect between group and time for prostate cancer knowledge scores (P<0.05). The increase in scores from baseline to post-intervention was 4.53 points in the intervention group, which was greater than the 2.05 points observed in the control group. Conclusion Collaborative follow-up management can improve re-examination adherence and the completeness of treatment outcome records among examinees with PSA in the gray zone, enhance prostate cancer-related knowledge, and facilitate early detection of prostate cancer.