The use of PSA screening has led to downstaging and downgrading of prostate cancer at diagnosis, increasing detection of indolent disease. Active surveillance aims to reduce over-treatment by delaying or avoiding radical treatment and its associated morbidity. However, there is not a consensus on the selection criteria and monitoring schedules that should be used. This article aims to summarize the evidence supporting the safety of active surveillance, the current selection criteria recommended and in use, the incidence of active surveillance, barriers existing to its uptake and future developments in patient selection.
Clinical genitourinary cancer. 2022 Sep 08 [Epub ahead of print]
Trent A Pattenden, Dhanika Samaranayke, Andrew Morton, Wee Loon Ong, Declan G Murphy, Elizabeth Pritchard, Susan Evans, Jeremy Millar, Venu Chalasani, Prem Rashid, Matthew Winter, Ian Vela, David Pryor, Stephen Mark, Nathan Lawrentschuk, Isaac A Thangasamy
Department of Urology, Ipswich Hospital, QLD, Australia. Electronic address: ., Department of Urology, Ipswich Hospital, QLD, Australia; Faculty of Medicine, University of Queensland, QLD, Australia., Alfred Health Radiation Oncology Service, VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, VIC, Australia; School of Clinical Medicine, University of Cambridge, UK., Division of Cancer Surgery, Peter MacCallum Cancer Centre, VIC, Australia., Department of Epidemiology and Preventive Medicine, Monash University, VIC, Australia., Alfred Health Radiation Oncology Service, VIC, Australia; Central Clinical School, Monash University, VIC, Australia., Faculty of Medicine and Health, University of Sydney, NSW, Australia., Rural Clinical School, Faculty of Medicine, University of New South Wales, Australia., Nepean Urology Research Group, Nepean Hospital, NSW, Australia., Department of Urology, Princess Alexandra Hospital, QLD, Australia; Australian Prostate Cancer Research Centre, Queensland and The Queensland Bladder Cancer Initiative, School of Biomedical Science, Faculty of Health, Queensland University of Technology, QLD, Australia., Department of Radiation Oncology, Princess Alexandra Hospital, QLD, Australia., Department of Urology, Christchurch Hospital, New Zealand., Division of Cancer Surgery, Peter MacCallum Cancer Centre, VIC, Australia; EJ Whitten Prostate Cancer Research Centre, Epworth, VIC, Australia., Faculty of Medicine, University of Queensland, QLD, Australia; Nepean Urology Research Group, Nepean Hospital, NSW, Australia.