Ronald C Chen1, Sabrina G Prime2, Ramsankar Basak3, Dominic Himchan Moon4, Claire Liang5, Deborah S Usinger6, Aaron J Katz7. 1. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, Kansas. Electronic address: rchen2@kumc.edu. 2. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. 3. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas. 5. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 6. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 7. Department of Population Health, University of Kansas School of Medicine, Kansas City, Kansas.
Abstract
PURPOSE: 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. METHODS AND MATERIALS: We used data from a population-based cohort of active-surveillance patients to examine the rigor of surveillance monitoring in the general population. RESULTS: Among 1419 patients enrolled from 2011 to 2013 throughout the state of North Carolina 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 examination, and prostate biopsy) within the first 2 years. Furthermore, adherence was <20% in all patient subgroups. CONCLUSIONS: 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.
PURPOSE: 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. METHODS AND MATERIALS: We used data from a population-based cohort of active-surveillance patients to examine the rigor of surveillance monitoring in the general population. RESULTS: Among 1419 patients enrolled from 2011 to 2013 throughout the state of North Carolina 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 examination, and prostate biopsy) within the first 2 years. Furthermore, adherence was <20% in all patient subgroups. CONCLUSIONS: 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.
Authors: Ronald C Chen; William R Carpenter; Mimi Kim; Laura H Hendrix; Robert P Agans; Anne-Marie Meyer; Anna Hoffmeyer; Bryce B Reeve; Matthew E Nielsen; Deborah S Usinger; Tara S Strigo; Anne M Jackman; Mary Anderson; Paul A Godley Journal: J Comp Eff Res Date: 2015-01 Impact factor: 1.744
Authors: Jeffrey J Tosoian; Mufaddal Mamawala; Jonathan I Epstein; Patricia Landis; Katarzyna J Macura; Demetrios N Simopoulos; H Ballentine Carter; Michael A Gorin Journal: Eur Urol Date: 2020-01-07 Impact factor: 20.096
Authors: Kevin B Ginsburg; Gregory B Auffenberg; Ji Qi; Isaac J Powell; Susan M Linsell; James E Montie; David C Miller; Michael L Cher Journal: Eur Urol Date: 2018-08-31 Impact factor: 20.096
Authors: Amy N Luckenbaugh; Gregory B Auffenberg; Scott R Hawken; Apoorv Dhir; Susan Linsell; Sanjeev Kaul; David C Miller Journal: J Urol Date: 2016-09-20 Impact factor: 7.450
Authors: Freddie C Hamdy; Jenny L Donovan; J Athene Lane; Malcolm Mason; Chris Metcalfe; Peter Holding; Michael Davis; Tim J Peters; Emma L Turner; Richard M Martin; Jon Oxley; Mary Robinson; John Staffurth; Eleanor Walsh; Prasad Bollina; James Catto; Andrew Doble; Alan Doherty; David Gillatt; Roger Kockelbergh; Howard Kynaston; Alan Paul; Philip Powell; Stephen Prescott; Derek J Rosario; Edward Rowe; David E Neal Journal: N Engl J Med Date: 2016-09-14 Impact factor: 91.245
Authors: Andrew J Roth; Barry Rosenfeld; Alice B Kornblith; Christopher Gibson; Howard I Scher; Tracy Curley-Smart; Jimmie C Holland; William Breitbart Journal: Cancer Date: 2003-06-01 Impact factor: 6.860
Authors: Ronald C Chen; R Bryan Rumble; D Andrew Loblaw; Antonio Finelli; Behfar Ehdaie; Matthew R Cooperberg; Scott C Morgan; Scott Tyldesley; John J Haluschak; Winston Tan; Stewart Justman; Suneil Jain Journal: J Clin Oncol Date: 2016-02-16 Impact factor: 44.544
Authors: Martin G Sanda; Jeffrey A Cadeddu; Erin Kirkby; Ronald C Chen; Tony Crispino; Joann Fontanarosa; Stephen J Freedland; Kirsten Greene; Laurence H Klotz; Danil V Makarov; Joel B Nelson; George Rodrigues; Howard M Sandler; Mary Ellen Taplin; Jonathan R Treadwell Journal: J Urol Date: 2017-12-15 Impact factor: 7.450
Authors: Archana Radhakrishnan; Lauren P Wallner; Ted A Skolarus; Arvin K George; Bradley H Rosenberg; Paul Abrahamse; Sarah T Hawley Journal: J Urol Date: 2022-05-06 Impact factor: 7.600