How Active Should Active Surveillance Be for Prostate Cancer?

Active surveillance (AS) is increasingly accepted as a standard of care for men with low-risk prostate cancer. However, consensus about how to implement AS is lacking.

Now, investigators have analyzed data from four AS study cohorts to evaluate the risks for disease progression — specifically, for upgrading from a Gleason score of ≤6 to ≥7 — that are associated with various prostate cancer biopsy intervals. The cohorts comprised 2576 men (age, 40–80 years) who received diagnosis of prostate cancer (stage T1 or T2; Gleason score, 2–6) between 1995 and 2014.

When all four cohorts were balanced with respect to inclusion criteria, surveillance intervals, competing treatments, and endpoints, large differences (25%–65%), likely attributed to differ…