Prostate Cancer: Low-volume Centers Less Likely to Employ Active Surveillance
Researchers evaluated data from 115,208 patients with low-risk prostate cancer diagnosed between 2010 and 2014 to determine the frequency of active surveillance and factors associated with receipt of
Among patients with low-risk prostate cancer, active surveillance has become an increasingly common strategy since 2010, though with considerable variability among institutions, according to research published in Cancer.1
Active surveillance has emerged as the recommended treatment strategy for patients with low-risk disease; surveillance includes regular testing (prostate specific antigen [PSA], biopsies, and physical examinations) until disease progression, after which patients begin therapy. There is, however, variation among institutions regarding how often active surveillance is employed.
For this retrospective study, researchers evaluated data from 115,208 patients with low-risk prostate cancer diagnosed between 2010 and 2014 to determine the frequency of active surveillance and factors associated with receipt of the treatment strategy.
In 2010, 6.8% of patients received active surveillance; this figure increased to 19.9% by 2014, indicating a 28.8% annual percentage increase. Patients at community cancer centers were twice as likely (odds ratio [OR], 2.00; P < .001) to receive active surveillance as those treated at comprehensive community cancer centers. Patients at academic institutions had an OR for active surveillance of 2.47 (P < .001) vs comprehensive community cancer centers.
The OR for active surveillance in high-volume cancer centers vs low-volume centers was 3.57 (P < .001).
The authors concluded that policies “to achieve consistent and higher rates of active surveillance, when appropriate, should be a priority of professional societies and patient advocacy groups.”
- Löppenberg B, Friedlander DF, Krasnova A, et al. Variation in the use of active surveillance for low-risk prostate cancer. Cancer. 2017 Sep 13. doi: 10.1002/cncr.30983 [Epub ahead of print]