Page 406 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
P. 406

Appendix Table C3.1 Studies on offer, acceptance, and adherence of active surveillance (continued)
                                               Factors examined                    Author               Study approach                  AS/WW definitions                    Findings               Issues
                                                                                    Year
                                                                                   PMID
                                        Physician          Ramsey  182       Survey of 238 men (multi-center)        AS (not explicitly        •  Urologists recommended            •  Cannot establish
                                        factors affecting  2011              with newly dx’d localized T1-3          provided)                 0.52 more treatment options (SE      causality for more RP
                                        offer              20959991          disease and 25 urologists                                         0.19, P <0.001) in initial           recommended by
                                                                             concerning their office encounters                                consultation than in second          urologists; plausible that
                                                                             (initial consultation vs. second                                  opinion visit                        patients sought out
                                                                             opinion); survey of patients and                                  •  For low risk disease, 25%         urologists for a second
                                                                             their urologist in urology clinics in 3                           urologists recommended AS,           opinion because the
                                                                             states (Family And Cancer Therapy                                 77% recommended RP in initial        patients were more
                                                                             Selection study, Charleston, SC;                                  consultation; 16% urologists         interested in RP
                                                                             Los Angeles, CA; San Antonio, Tx);                                recommended AS, 91%                  •  Applicability limited to
                                                                             pt recruitment occurred at the                                    recommended RP in second             patients/urologists in
                                                                             urology clinics; 423 invited, 240 met                             opinion visit                        academic centers
                                                                             eligibility criteria; 238 analyzed (2                             •  Discrepancy between what
                                                                             excluded for unspecified                                          physicians recommended and
                                                                             consultation type)                                                what patients heard physicians
                                                                                                                                               recommended: in patients for
                                                                                                                                               whom urologists recommended
                                                                                                                                               RP, 67% patients heard the
                                                                                                                                               recommendation; in patients for
                                                                                                                                               whom urologists recommended
                                                                                                                                               RT or ADT, ~25% patients heard
                                                                                                                                               the recommendation
                                        Physician          Steginga 192      Interview of 108 men with newly         WW (not explicitly        •  Unprompted recall of their        •  Limited applicability to
                                        factors affecting  2002              dx’d localized prostate cancer from     provided)                 urological consultation: 71% of      US
                                        offer              11856106          2 hospital clinics and 4 urology                                  the physicians discussed WW;
                                                                             practices in Queensland, Australia;                               92% discussed RP, and 87%
                                                                             men were referred by their                                        discussed RT
                                                                             urologists to the project if they have
                                                                             localized disease (no metastatic
                                                                             disease on scans and X-rays)
                                                                             suitable for curative treatment; 131
                                                                             consecutive men were referred;
                                                                             119 eligible (newly dx’d localized
                                                                             disease, communicate in English;
                                                                             no head injury, dementia,
                                                                             concurrent psychiatric illness and
                                                                             cancer), 108 participated







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