Receipt of guideline-recommended surveillance in a population-based cohort of active surveillance prostate cancer patients.

Prospective clinical trials have demonstrated the safety and efficacy of active surveillance for men with localized prostate cancer, but also suggested that inadequate surveillance may risk missing an opportunity for cure. We used data from a population-based cohort of active surveillance patients to examine the rigor of surveillance monitoring in the general population. Among 1,419 patients enrolled from 2011-2013 throughout the State of XXXXX in collaboration with the state cancer registry and followed prospectively, 346 pursued active surveillance. Only 13% received all guideline-recommended surveillance testing (including prostate specific antigen, digital rectal exam, and prostate biopsy) within the first two years. Further, adherence was <20% in all patient subgroups. These findings suggest that "active surveillance" as implemented in the general population may not represent the rigorous monitoring regimens used in the studies that demonstrated the safety of this management approach. More real-world studies on active surveillance are needed.

International journal of radiation oncology, biology, physics. 2021 Jan 13 [Epub ahead of print]

Ronald C Chen, Sabrina G Prime, Ramsankar Basak, Dominic Himchan Moon, Claire Liang, Deborah S Usinger, Aaron J Katz

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill; Department of Radiation Oncology, University of Kansas Cancer Center. Electronic address: ., University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA., Department of Radiation Oncology, University of North Carolina at Chapel Hill., Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA., University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill., Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA.