Page 410 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer

Appendix Table C3.1 Studies on offer, acceptance, and adherence of active surveillance (continued)
Factors examined Author Study approach
Year
PMID
Patient factors Anandadas 195 Prospective, multicenter study of
affecting 2011 768 men with low-risk T1/T2 cancer
treatment 21083643 who were referred to centers that
choice offered 4 treatment options (RP,
RT, brachytherapy, or AS).
Reasons for selecting treatment
were recorded.
821 men from 7 different uro-
oncology centers in UK were
enrolled (all were initially referred
for active treatment for early
prostate cancer); 53 were recruited
before brachytherapy was offered,
they therefore were excluded from
the analysis
Patient factors Xu 196 Patients with newly dx’d localized
affecting 2011 disease were recruited from 3
treatment 21830629 urology offices and 1 radiation
choice oncology office in Detroit and also
through flyers in hospitals and
doctors’ offices; sampling aim was
to maximize a broad range of
experiences, no problem recruiting
men who chose RP or RT, had
difficulty recruiting men who chose
WW; semistructured interview of 21
men with localized cancer <75 y;
attempted to select a diverse
sample of men based on race, age,
social class, and income; easily
recruited patients who chose
AS/WW definitions Findings Issues
”AS” (not explicitly • 61/768 (8%) chose AS • Incomplete analysis of
provided) • AS was more frequently reasons for choosing AS.
chosen over time (2000: 0%; Most of those who
2006 ~20%) selected “Other” chose
• Reasons for choosing AS: AS, but the other reasons
o More convenient for lifestyle are unexplained.
16% (compared to all 4 • It was not explicitly
treatments: 17%) stated who provided
o Fear of side effects 11% reason for treatment
(compared to all 4 choice, though implicitly
treatments: 9%) the patient himself.
o Fear of other options 8%
(compared to all 4
treatments: 12%)
o Combination of reasons
16% (compared to all 4
treatments: 15%)
o Other 23% (including “didn’t
want active or invasive
treatment”) (compared to all
4 treatments: 6%)
o Unknown 25% (compared
to all 4 treatments: 17%)
WW (not explicitly • “For most men, both black • Only 2 patients with
provided) and white, treatment decision WW
making occurred within an
emotional context of fear and
uncertainty and without
systematic use of information.”
• Reasons why WW chosen
(n=2):
o Maintain current QoL
o Cancer small or slow-
growing, may never cause
problems; “If it’s not bothering
me, why mess with it”
o Will be able to act if cancer
progresses
o God will take care of it
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