Nearly 10% of patients with prostate cancer lost to follow up

Michael Cher

Almost one in 10 patients with prostate cancer who were under active surveillance were lost to follow up, according to findings recently presented at the American Urological Association annual meeting.

“If we are to advocate for active surveillance, we have to make sure that the surveillance is active,” Michael Cher, MD, of the Michigan Urological Surgery Improvement Collaborative and one of the study’s researchers, told Healio Family Medicine. “The least ‘active’ thing that could happen would be to lose track of the patient. Patients whose disease progresses may lose the opportunity to be treated appropriately.”

Researchers identified 2,211 men from Michigan who had prostate cancer and were on active surveillance from 2011 to 2015. They defined lost to follow up as any 18-month period where the was no PSA, prostate CT or MRI or biopsy in a patient’s file.

Cher and colleagues found that 217 of the men (9.8%) were lost to follow-up. African-Americans were more likely to be lost to follow up vs. whites (17% vs. 7.4%). Of the 217 lost to follow up, 184 were considered prolonged lost to follow up, meaning there was no data about their lost to follow-up event, while the remaining 33 were considered insufficient follow-up, with a lost-to-follow-up event, but with later data.

“The results were not really surprising but serve as a warning that we must not only consider who to put on surveillance initially, but how to perform surveillance in the long run. This means keeping track of patients,” Cher said in the interview.

He offered some ways clinicians can use the findings to improve patient care.

“Consider implementing systems of care that raise a warning or a red flag if a patient on surveillance fails to show up for his intended appointment. It is also important to get the patient to understand that they bear some responsibility for their care as well.”– by Janel Miller

Reference: Ginsburg K, et al. Rates and risk factors of lost to follow-up in prostate cancer patients managed with active surveillance. Presented at: The American Urological Association Annual Meeting; May 18-21, 2018; San Francisco.

Disclosure: Healio Family Medicine could not confirm relevant financial disclosures prior to publication.