Active surveillance of men with low risk prostate cancer

Low risk prostate cancer is increasingly being managed with active surveillance (AS). This study aimed to describe the practice of active surveillance by examining the characteristics of those who commence AS, the rate of adherence to follow-up protocols over 2 years and factors associated with good adherence. Using data from the Prostate Cancer Outcomes Registry in Victoria, 1635 men were included in the analysis. In this cohort, only 26.5% adhered to the AS protocol. A significant predictor of adherence was being diagnosed in a private hospital. A significant predictor of non-adherence included being diagnosed by transurethral resection of the prostate or transperineal bioposy; and being over 65 years at diagnosis. Active surveillance was not implemented according to published protocols in almost three-quarters of men diagnosed with low risk prostate cancer. Lack of surveillance increase the risk that men miss the opportunity to be treated with curative intent and these patient, clinician and health service factors need to be investigated further.

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