TY - JOUR
T1 - Aligning evidence and practice
T2 - Future research needs to increase utilization of active surveillance for favorable risk prostate cancer
AU - Carter, H. Ballentine
PY - 2015/5/27
Y1 - 2015/5/27
N2 - Purpose of review The prolonged natural history of prostate cancers detected through prostate-specific antigen-based testing has resulted in many men today undergoing treatment for prostate cancer that will not improve health outcomes. Active surveillance is an underutilized approach to reducing overtreatment of favorable risk prostate cancer. This review outlines the areas for future research that could improve the uptake of active surveillance as a management option. Recent findings The reasons for limited uptake of active surveillance for favorable risk prostate cancer are multifactorial and complex. The variability in management of favorable risk disease among older men can be attributed to a greater extent to the individual physician rather than tumor and patient characteristics. Increased uptake of active surveillance will depend on improved risk stratification at diagnosis, surveillance protocol standardization, and patient decision support that accounts for individual patient preferences. Summary The disconnect between evidence and practice with respect to management of favorable risk prostate cancer has resulted in overtreatment. Active surveillance as a management option for favorable risk disease may become more acceptable to patients and physicians as research needs are met.
AB - Purpose of review The prolonged natural history of prostate cancers detected through prostate-specific antigen-based testing has resulted in many men today undergoing treatment for prostate cancer that will not improve health outcomes. Active surveillance is an underutilized approach to reducing overtreatment of favorable risk prostate cancer. This review outlines the areas for future research that could improve the uptake of active surveillance as a management option. Recent findings The reasons for limited uptake of active surveillance for favorable risk prostate cancer are multifactorial and complex. The variability in management of favorable risk disease among older men can be attributed to a greater extent to the individual physician rather than tumor and patient characteristics. Increased uptake of active surveillance will depend on improved risk stratification at diagnosis, surveillance protocol standardization, and patient decision support that accounts for individual patient preferences. Summary The disconnect between evidence and practice with respect to management of favorable risk prostate cancer has resulted in overtreatment. Active surveillance as a management option for favorable risk disease may become more acceptable to patients and physicians as research needs are met.
KW - active surveillance
KW - favorable risk prostate cancer
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=84928552780&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928552780&partnerID=8YFLogxK
U2 - 10.1097/MOU.0000000000000153
DO - 10.1097/MOU.0000000000000153
M3 - Review article
C2 - 25692722
AN - SCOPUS:84928552780
SN - 0963-0643
VL - 25
SP - 277
EP - 282
JO - Current opinion in urology
JF - Current opinion in urology
IS - 3
ER -