Active Surveillance Underused for Low-Risk PCa

Most physicians report that their patients are not interested in AS.
Most physicians report that their patients are not interested in AS.

Although most prostate cancer specialists believe active surveillance to be effective and underused, fewer endorse active surveillance than other therapies for low-risk prostate cancer, according to a study published in the July issue of Medical Care.

Simon P. Kim, M.D., M.P.H., from Yale University in New Haven, Conn., and colleagues surveyed 1,366 radiation oncologists and urologists about their perceptions of active surveillance and recommendations for low-risk prostate cancer treatment. Differences in physician perceptions on active surveillance and treatment recommendations were compared for 717 physicians that completed the survey.

The researcher found that 71.9 percent of physicians stated that active surveillance is effective, and 80.0 percent reported that it was underused in the United States.

However, most physicians (71.0 percent) reported that their patients were not interested in active surveillance. More physicians recommended radical prostatectomy (44.9 percent) or brachytherapy (35.4 percent), while fewer recommended active surveillance (22.1 percent) for low-risk prostate cancer.

Compared with radiation oncologists, urologists were more likely to recommend surgery and active surveillance (odds ratios, 4.19 and 2.55, respectively) but less likely to recommend brachytherapy and external beam radiation therapy (odds ratios, 0.13 and 0.11, respectively), in multivariable analysis.

"Most prostate cancer specialists in the United States believe active surveillance effective and underused for low-risk prostate cancer, yet continue to recommend the primary treatments their specialties deliver," the authors write.

One author disclosed financial ties to Medtronic Inc.

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