A National Survey of Radiation Oncologists and Urologists on Perceived Attitudes and Recommendations of Active Surveillance for Low-Risk Prostate Cancer

Simon P. Kim, Jon C. Tilburt, Nilay D. Shah, James B. Yu, Badrinath R Konety, Paul L. Nguyen, Robert Abouassaly, Stephen B. Williams, Cary P. Gross

Research output: Contribution to journalArticle

Abstract

Background: Clinical factors and barriers affecting adoption of active surveillance (AS) for low-risk prostate cancer (PCa) remain poorly understood. We performed a national survey of radiation oncologists (RO) and urologists (URO) about the perceptions and recommendations of AS for low-risk PCa. Materials and Methods: In 2017, we surveyed 915 RO and 940 URO about AS for low-risk PCa in the United States. Survey items queried respondents about their attitudes toward AS and recommendations of AS for low-risk PCa. Pearson chi-square and multivariable logistic regression identified clinical and physician factors related toward AS for low-risk PCa. Results: Overall, the response rate was 37.3% (n = 691) and was similar for RO and URO (35.7% vs. 38.7%; P =.18). RO were less likely to consider AS effective for low-risk PCa (86.5% vs. 92.0%; P =.04) and more likely to rate higher patient anxiety on AS (49.5% vs. 29.5%; P <.001) than URO. Recommendations of AS varied modestly on the basis of age, prostate-specific antigen (PSA), and number of cores positive for Gleason 3 + 3 PCa. For a 55-year-old man with PSA 8 with 6 cores of Gleason 6 PCa, both RO and URO infrequently recommended AS (4.4% vs. 5.2%; adjusted odds ratio = 0.6; P =.28). For a 75-year-old patient with PSA 4 with 2 cores of Gleason 6 PCa, URO and RO most often recommended AS (89.6% vs. 83.4%; adjusted odds ratio = 0.5; P =.07). Conclusion: RO and URO consider AS to be effective in the clinical management of low-risk PCa, but this varies by clinical and physician factors.

Original languageEnglish (US)
Pages (from-to)e472-e481
JournalClinical Genitourinary Cancer
Volume17
Issue number3
DOIs
StatePublished - Jun 1 2019

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Prostatic Neoplasms
Prostate-Specific Antigen
Odds Ratio
Surveys and Questionnaires
Radiation Oncologists
Urologists
Physicians
Risk Management
Anxiety
Logistic Models

Keywords

  • Active surveillance
  • Physician bias
  • Prostate cancer
  • Survey

PubMed: MeSH publication types

  • Journal Article

Cite this

A National Survey of Radiation Oncologists and Urologists on Perceived Attitudes and Recommendations of Active Surveillance for Low-Risk Prostate Cancer. / Kim, Simon P.; Tilburt, Jon C.; Shah, Nilay D.; Yu, James B.; Konety, Badrinath R; Nguyen, Paul L.; Abouassaly, Robert; Williams, Stephen B.; Gross, Cary P.

In: Clinical Genitourinary Cancer, Vol. 17, No. 3, 01.06.2019, p. e472-e481.

Research output: Contribution to journalArticle

Kim, Simon P. ; Tilburt, Jon C. ; Shah, Nilay D. ; Yu, James B. ; Konety, Badrinath R ; Nguyen, Paul L. ; Abouassaly, Robert ; Williams, Stephen B. ; Gross, Cary P. / A National Survey of Radiation Oncologists and Urologists on Perceived Attitudes and Recommendations of Active Surveillance for Low-Risk Prostate Cancer. In: Clinical Genitourinary Cancer. 2019 ; Vol. 17, No. 3. pp. e472-e481.
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abstract = "Background: Clinical factors and barriers affecting adoption of active surveillance (AS) for low-risk prostate cancer (PCa) remain poorly understood. We performed a national survey of radiation oncologists (RO) and urologists (URO) about the perceptions and recommendations of AS for low-risk PCa. Materials and Methods: In 2017, we surveyed 915 RO and 940 URO about AS for low-risk PCa in the United States. Survey items queried respondents about their attitudes toward AS and recommendations of AS for low-risk PCa. Pearson chi-square and multivariable logistic regression identified clinical and physician factors related toward AS for low-risk PCa. Results: Overall, the response rate was 37.3{\%} (n = 691) and was similar for RO and URO (35.7{\%} vs. 38.7{\%}; P =.18). RO were less likely to consider AS effective for low-risk PCa (86.5{\%} vs. 92.0{\%}; P =.04) and more likely to rate higher patient anxiety on AS (49.5{\%} vs. 29.5{\%}; P <.001) than URO. Recommendations of AS varied modestly on the basis of age, prostate-specific antigen (PSA), and number of cores positive for Gleason 3 + 3 PCa. For a 55-year-old man with PSA 8 with 6 cores of Gleason 6 PCa, both RO and URO infrequently recommended AS (4.4{\%} vs. 5.2{\%}; adjusted odds ratio = 0.6; P =.28). For a 75-year-old patient with PSA 4 with 2 cores of Gleason 6 PCa, URO and RO most often recommended AS (89.6{\%} vs. 83.4{\%}; adjusted odds ratio = 0.5; P =.07). Conclusion: RO and URO consider AS to be effective in the clinical management of low-risk PCa, but this varies by clinical and physician factors.",
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AU - Tilburt, Jon C.

AU - Shah, Nilay D.

AU - Yu, James B.

AU - Konety, Badrinath R

AU - Nguyen, Paul L.

AU - Abouassaly, Robert

AU - Williams, Stephen B.

AU - Gross, Cary P.

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AB - Background: Clinical factors and barriers affecting adoption of active surveillance (AS) for low-risk prostate cancer (PCa) remain poorly understood. We performed a national survey of radiation oncologists (RO) and urologists (URO) about the perceptions and recommendations of AS for low-risk PCa. Materials and Methods: In 2017, we surveyed 915 RO and 940 URO about AS for low-risk PCa in the United States. Survey items queried respondents about their attitudes toward AS and recommendations of AS for low-risk PCa. Pearson chi-square and multivariable logistic regression identified clinical and physician factors related toward AS for low-risk PCa. Results: Overall, the response rate was 37.3% (n = 691) and was similar for RO and URO (35.7% vs. 38.7%; P =.18). RO were less likely to consider AS effective for low-risk PCa (86.5% vs. 92.0%; P =.04) and more likely to rate higher patient anxiety on AS (49.5% vs. 29.5%; P <.001) than URO. Recommendations of AS varied modestly on the basis of age, prostate-specific antigen (PSA), and number of cores positive for Gleason 3 + 3 PCa. For a 55-year-old man with PSA 8 with 6 cores of Gleason 6 PCa, both RO and URO infrequently recommended AS (4.4% vs. 5.2%; adjusted odds ratio = 0.6; P =.28). For a 75-year-old patient with PSA 4 with 2 cores of Gleason 6 PCa, URO and RO most often recommended AS (89.6% vs. 83.4%; adjusted odds ratio = 0.5; P =.07). Conclusion: RO and URO consider AS to be effective in the clinical management of low-risk PCa, but this varies by clinical and physician factors.

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