A National Survey of Radiation Oncologists and Urologists on Perceived Attitudes and Recommendations of Active Surveillance for Low-Risk Prostate Cancer.

Clinical factors and barriers affecting adoption of active surveillance (AS) for low-risk prostate cancer (PCa) remain poorly understood. We performed a national survey of radiation oncologists (RO) and urologists (URO) about the perceptions and recommendations of AS for low-risk PCa.

In 2017, we surveyed 915 RO and 940 URO about AS for low-risk PCa in the United States. Survey items queried respondents about their attitudes toward AS and recommendations of AS for low-risk PCa. Pearson chi-square and multivariable logistic regression identified clinical and physician factors related toward AS for low-risk PCa.

Overall, the response rate was 37.3% (n = 691) and was similar for RO and URO (35.7% vs. 38.7%; P = .18). RO were less likely to consider AS effective for low-risk PCa (86.5% vs. 92.0%; P = .04) and more likely to rate higher patient anxiety on AS (49.5% vs. 29.5%; P < .001) than URO. Recommendations of AS varied modestly on the basis of age, prostate-specific antigen (PSA), and number of cores positive for Gleason 3 + 3 PCa. For a 55-year-old man with PSA 8 with 6 cores of Gleason 6 PCa, both RO and URO infrequently recommended AS (4.4% vs. 5.2%; adjusted odds ratio = 0.6; P = .28). For a 75-year-old patient with PSA 4 with 2 cores of Gleason 6 PCa, URO and RO most often recommended AS (89.6% vs. 83.4%; adjusted odds ratio = 0.5; P = .07).

RO and URO consider AS to be effective in the clinical management of low-risk PCa, but this varies by clinical and physician factors.

Clinical genitourinary cancer. 2019 Feb 07 [Epub ahead of print]

Simon P Kim, Jon C Tilburt, Nilay D Shah, James B Yu, Badrinath Konety, Paul L Nguyen, Robert Abouassaly, Stephen B Williams, Cary P Gross

Division of Urology, University of Colorado-Denver, Denver, CO; Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, Yale University, New Haven, CT. Electronic address: ., Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN; Division of Bioethics, Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN., Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN; Division of Health Policy & Research, Mayo Clinic, Rochester, MN., Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, Yale University, New Haven, CT; Department of Radiation Oncology, Yale University, New Haven, CT., Department of Urology, University of Minnesota, Minneapolis, MN., Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH; Louis Stokes, Cleveland VA Medical Center, Cleveland, OH., University of Texas Medical Branch, Division of Urology, Galveston, TX., Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, Yale University, New Haven, CT; Department of Medicine, Yale University, New Haven, CT.

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