PURPOSE OF REVIEW: The prolonged natural history of prostate cancers detected through prostate-specific antigen-based testing has resulted in many men today undergoing treatment for prostate cancer that will not improve health outcomes.
Active surveillance is an underutilized approach to reducing over-treatment of favorable risk prostate cancer. This review outlines the areas for future research that could improve the uptake of active surveillance as a management option.
RECENT FINDINGS: The reasons for limited uptake of active surveillance for favorable risk prostate cancer are multifactorial and complex. The variability in management of favorable risk disease among older men can be attributed to a greater extent to the individual physician rather than tumor and patient characteristics. Increased uptake of active surveillance will depend on improved risk stratification at diagnosis, surveillance protocol standardization, and patient decision support that accounts for individual patient preferences.
SUMMARY: The disconnect between evidence and practice with respect to management of favorable risk prostate cancer has resulted in over-treatment. Active surveillance as a management option for favorable risk disease may become more acceptable to patients and physicians as research needs are met.
Carter HB. Are you the author?
Department of Urology, Johns Hopkins University School of Medicine, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Reference: Curr Opin Urol. 2015 Feb 16. Epub ahead of print.