Aligning evidence and practice: Future research needs to increase utilization of active surveillance for favorable risk prostate cancer

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalCurrent Opinion in Urology
Volume25
Issue number3
DOIs
StatePublished - May 27 2015

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Prostatic Neoplasms
Risk Management
Physicians
Patient Preference
Prostate-Specific Antigen
Health
Research
Neoplasms
Medical Overuse
Therapeutics

Keywords

  • active surveillance
  • favorable risk prostate cancer
  • prostate cancer

ASJC Scopus subject areas

  • Urology

Cite this

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abstract = "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.",
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