A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer.

Researchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.

To develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.

We first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.

An educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts - mortality and morbidity risk and diet and lifestyle advice.

The proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5yr after AS selection using multivariate logistic regression.

Common themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p=0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.

The AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5yr.

Men on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5yr.

European urology oncology. 2018 Oct 11 [Epub]

Netty Kinsella, Kerri Beckmann, Declan Cahill, Oussama Elhage, Rick Popert, Paul Cathcart, Ben Challacombe, Christian Brown, Mieke Van Hemelrijck

Department of Uro-Oncology, The Royal Marsden Hospital, London, UK; Translational Oncology and Urology Research, King's College London, London, UK; Centre for Population Health Research, University of South Australia, Adelaide, Australia. Electronic address: ., Translational Oncology and Urology Research, King's College London, London, UK; Centre for Population Health Research, University of South Australia, Adelaide, Australia; Department of Urology, Guys and St. Thomas NHS Foundation Trust, London, UK., Department of Uro-Oncology, The Royal Marsden Hospital, London, UK., Department of Urology, Guys and St. Thomas NHS Foundation Trust, London, UK; MRC Transplantation, King's College London, London, UK., Department of Urology, Guys and St. Thomas NHS Foundation Trust, London, UK., Department of Urology, Guys and St. Thomas NHS Foundation Trust, London, UK; Department of Urology, Kings Hospital, London, UK., Translational Oncology and Urology Research, King's College London, London, UK; Centre for Population Health Research, University of South Australia, Adelaide, Australia.

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