More Black Men Prefer Active Surveillance for Low-Risk Prostate Cancer

More than half of newly diagnosed patients with low-risk prostate cancer (LRPC) chose active surveillance (AS), with recommendation from a urologist being the strongest determinant of AS uptake, according to a study published online Jan. 22 in Cancer.

Active surveillance is a means of monitoring the LRPC closely, only treating it if it progresses.

Jinping Xu, M.D., from the Wayne State University School of Medicine in Detroit, and colleagues examined factors influencing AS uptake in a survey administered to Black and White newly diagnosed patients with LRPC who were aged 75 years or older. Data were included for 1,688 participants identified through metro‐Detroit and Georgia population‐based cancer registries.

The researchers found that 57 percent of the study participants chose AS over definitive treatment (51 and 61 percent of Black and White participants, respectively).

Older age, White race, and higher education were patient factors associated with initial AS uptake in an unadjusted analysis. None of these factors were significant predictors of AS uptake after adjustment for covariates.

AS recommendation by a urologist was the strongest determinant of AS uptake (adjusted prevalence ratio, 6.59). Shared patient-physician treatment decision, greater prostate cancer knowledge, and residence in metro‐Detroit compared with Georgia were other factors associated with the decision to undergo AS.

The likelihood of choosing AS was lower for men whose decision was strongly influenced by the desire to achieve “cure” or “live longer” with treatment and those who perceived their LRPC diagnosis as more serious.

“This indicates that patient perceptions and acceptance of AS have improved over time, although geographical and racial differences in uptake remain,” the authors write.

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