HealthDay News — For men with low-risk prostate cancer, factors such as ethnicity influence patient decision to pursue active treatment during active surveillance, according to a study published online in The Journal of Urology.

Scott P. Kelly, PhD, from the Georgetown University Medical Center in Washington, DC, and colleagues conducted a retrospective study involving 2,228 men diagnosed with low-risk prostate cancer who did not receive treatment within the first year of diagnosis. Factors associated with time from diagnosis to active treatment were examined.

The researchers found that 27% of the men began active treatment at a median of 2.9 years during follow-up. Compared with non-Hispanic white men, non-Hispanic black men were marginally more likely to begin active treatment, independent of baseline and follow-up clinical measures (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.0 to 1.7). Among those who remained on observation, rebiopsy within 24 months of diagnosis occurred at a slightly lower rate for non-Hispanic black than non-Hispanic white men (HR, 0.70; 95% CI, 0.60 to 1.0). Independent of race, Gleason grade progression (HR, 3.3; 95% CI, 2.7 to 4.1) and prostate-specific antigen doubling time less than 48 months (HR, 2.9; 95% CI, 2.3 to 3.7) correlated with active treatment initiation.

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“Sociodemographic factors such as ethnicity and education may independently influence the patient decision to pursue active treatment and serial biopsies during active surveillance,” the authors write.

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  1. Kelly SP, Van Den Eeden SK, Hoffman RM, et al. Sociodemographic and Clinical Predictors of Switching to Active Treatment among a Large, Ethnically Diverse Cohort of Men with Low Risk Prostate Cancer on Observational Management. J Urology. 2016; doi: 10.1016/j.juro.2016.04.045
  2. Dall’Era MA. Reasons for Abandonment of Active Surveillance in Men with Prostate Cancer. J Urology. 2016; doi: 10.1016/j.juro.2016.06.078