Very few older man receive the intensity of active surveillance testing recommended by major prospective active surveillance (AS) programs, a study published in the Journal of Urology has shown.1

Although major prostate cancer active surveillance programs recommend repeat testing of prostate-specific antigen (PSA) and prostate biopsy, adherence to such testing remains unknown. Therefore, researchers sought to determine whether men in the community receive the same intensity of active surveillance testing as in prospective active surveillance protocols.

For the retrospective study, researchers analyzed data from 5192 men age 66 years or older undergoing active surveillance for prostate cancer. Patients had not received curative therapy in the year after diagnosis and had undergone 1 or more postdiagnosis prostate biopsies.

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Results showed that more than 80% had at least 1 PSA test per year but less than 13% received a prostate biopsy beyond the first 2 years. Patients rarely underwent MRI screening.

Researchers found that recent diagnosis and higher income were associated with higher frequency of surveillance prostate biopsy. In contrast, older age and greater comorbidity were associated with fewer biopsies. African American patients were less likely to undergo PSA testing.

The study also demonstrated that during 5 years of active surveillance, only 11.1% met the testing standards of the Sunnybrrok/PRIAS program and only 5.0% met the standards of the Johns Hopkins programs.


1. Loeb S, Walter D, Curnyn C, et al. How active is active surveillance? Intensity of follow-up during active surveillance for prostate cancer in the United States [published online ahead of print March 2, 2016]. J Urol. doi:10.1016/j.juro.2016.02.2963.