Clinical evaluation of an individualized risk prediction tool for men on active surveillance for prostate cancer

To determine whether providing individualized predictions of health outcomes to men on active surveillance (AS) alleviates cancer-related anxiety and improves risk understanding.

We consecutively recruited men from our large, institutional AS program before (n=36) and after (n=31) implementation of a risk prediction tool. Men in both groups were surveyed before and after their regular visits to assess their perceived cancer control, biopsy-specific anxiety, and burden from cancer-related information. We compared pre-/post-visit differences between men who were and were not shown the tool using two-sample t-tests. Satisfaction with and understanding of the predictions were elicited from men in the intervention period.

Men reported a relatively high level of cancer control at baseline. Men who were not shown the tool saw a 6.3 point increase (scaled from 0 to 100) in their perceived cancer control from before to after their visit whereas men who were shown the tool saw a 12.8 point increase, indicating a statistically significant difference between groups (p=0.04). Biopsy-specific anxiety and burden from cancer information was not significantly different between groups. Men were satisfied with the tool and demonstrated moderate understanding.

Providing individualized predictions to men on AS helps them better understand their cancer risk and should be considered at other clinical sites.

Urology. 2018 Aug 29 [Epub ahead of print]

Joseph H Huntley, Rebecca Y Coley, H Ballentine Carter, Archana Radhakrishnan, Melinda Krakow, Craig E Pollack

Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: ., Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. Electronic address: ., Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: ., Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: ., National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address: ., Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: .

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