Dr. Koo on Active Surveillance Rates in Prostate Cancer

Alec Koo, MD, FACS, managing partner, Skyline Urology, board of directors, Large Urology Group Practice Association, discusses results from a recent study on active surveillance in prostate cancer.

Koo explains one of the main issues in localized prostate cancer, which has potentially led to criticism of prostate specific antigen (PSA) testing, is that patients who are screened and diagnosed with the disease are over-treated.

Active surveillance should be implemented in patients who have recently been diagnosed or have low-risk for disease progression. Practitioners then weigh disease stage against patients' life expectancy and outlook on life, and have a shared decision-making process with patients regarding a treatment plan, Koo says. Active surveillance is most appropriate in patients who are classified with low-risk or very low-risk disease, he explains.

A recent study involving nine practices of 1900 patients over a 6-month period examined active surveillance rates. For the combined group of low-risk and very low-risk diseases, the active surveillance rate was 52% compared to previously reported active surveillance rates of 9% to 27%, Koo says.