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Active surveillance for prostate cancer significantly increased over time
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The use of active surveillance for men with low-risk prostate cancer increased over time, yet varied among individual facilities, according to findings published in Cancer.
“For men with low-risk prostate cancer, active surveillance has emerged as a quality of life-preserving alternative to definitive therapy,” Quoc-Dien Trinh, MD, assistant professor at Harvard Medical School, and colleagues wrote. “Reports on the use of active surveillance for localized prostate cancer have been variable.”
The researchers performed a retrospective, hospital-based study of 115,208 men who were diagnosed with low-risk prostate cancer between 2010 and 2014. Trinh and colleagues used multivariate and mixed effects models to identify factors linked with use of active surveillance.
Active surveillance rose from 6.8% in 2010 to 19.9% in 2014 (annual percentage change, 28.8%; 95% CI, 19.6-38.7).
However, the adjusted probability of active surveillance varied widely by institution. Patients treated at community cancer programs (OR = 2; 95% CI, 1.5-2.67) and academic institutions (OR = 2.47; 95% CI, 1.81-3.37) appeared more likely to receive active surveillance than those treated at comprehensive community cancer centers. Similarly, patients treated at very high-volume facilities (OR = 3.57; 95% CI, 1.94-6.55) appeared more likely to undergo active surveillance than those treated at very low-volume facilities.
Hospital and patient characteristics accounted for 60.2% of variation overall, whereas the institution providing treatment accounted for 91.5% of variability.
The researchers acknowledged limitations with the study, including its retrospective nature and because the variable researchers used to represent active surveillance did not discriminate between active surveillance and watchful waiting.
“The use of active surveillance for low-risk prostate cancer increased significantly over time,” Trinh and colleagues wrote. “Policies to achieve consistent and higher rates of active surveillance, when appropriate, should be a priority of professional societies and patient advocacy groups.” – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.