The uptake of active surveillance for the management of prostate cancer: A population-based analysis

Authors

  • Patrick O. Richard Princess Margaret Cancer Centre, University Health Network
  • Shabbir M.H. Alibhai
  • Tony Panzarella
  • Laurence Klotz
  • Maria Komisarenko
  • Neil E. Fleshner
  • David Urbach
  • Antonio Finelli

DOI:

https://doi.org/10.5489/cuaj.3684

Abstract

Introduction: Active surveillance (AS) is a strategy for the management of low-risk prostate cancer (PCa). However, few studies have assessed the uptake of AS at a population level and none of these
were based on a Canadian population. Therefore, our objectives were to estimate the proportion of men being managed by AS in Ontario and to assess the factors associated with its uptake.

Methods: This was a retrospective, population-based study using administrative databases from the province of Ontario to identify men ≤75 years diagnosed with localized PCa between 2002 and 2010. Descriptive statistics were used to estimate the proportion of men managed by AS, whereas mixed models were used to assess the factors associated with the uptake of AS.

Results: 45 691 men met our inclusion criteria. Of these, 18% were managed by AS. Over time, the rates of AS increased significantly from 11% to 21% (p<0.001). Older age, residing in an urban centre,
being diagnosed in the later years of the study period, having a neighborhood income in the highest quintile, and being managed by urologists were all associated with greater odds of receiving AS.

Conclusions: There has been a steady increase in the uptake of AS between 2002 and 2010. However, only 18% of men diagnosed with localized PCa were managed by AS during the study period. The decisions to adopt AS were influenced by several individual and physician characteristics. The data suggest that there is significant opportunity for more widespread adoption of AS.

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Author Biography

Patrick O. Richard, Princess Margaret Cancer Centre, University Health Network

Urology Oncology fellow

Department of surgical oncology, Division of urology

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Published

2016-10-13

How to Cite

Richard, P. O., Alibhai, S. M., Panzarella, T., Klotz, L., Komisarenko, M., Fleshner, N. E., Urbach, D., & Finelli, A. (2016). The uptake of active surveillance for the management of prostate cancer: A population-based analysis. Canadian Urological Association Journal, 10(9-10), 333–8. https://doi.org/10.5489/cuaj.3684

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Section

Original Research