Is Advocacy for Active Surveillance Over Definitive Intervention in Low-Risk Prostate Cancer Applicable to African American Patients?

11/14/17  Portland, Ore.

      In 2013, the Choosing Wisely campaign initiative inspired 5 American Society for Radiation Oncology-endorsedrecommendations (1), including "Don't initiate management of low-risk prostate cancer without discussing active surveillance." This recommendation was derived primarily from evidence provided by 2 prospective, randomized, controlled trials (RCTs) examining radical prostatectomy versus observation. The first, the Scandinavian Prostate Cancer Group Study, reported (with estimated 15-year results) that in low-risk prostate cancer (prostate-specific antigen [PSA] <10 ng/mL, Gleason score <7), radical prostatectomy did not significantly reduce prostate cancer specificemortality for the 695 patients randomized (2). The second, the Prostate Cancer Intervention versus Observation Trial (PIVOT), enrolled 761 US patients diagnosed by PSA screening...[PDF]