Journal article
Treatment Preferences for Active Surveillance versus Active Treatment among Men with Low-Risk Prostate Cancer
Cancer epidemiology, biomarkers & prevention, v 25(8), pp 1240-1250
01 Aug 2016
PMID: 27257092
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Due to the concerns about the overtreatment of low-risk prostate cancer, active surveillance (AS) is now a recommended alternative to the active treatments (AT) of surgery and radiotherapy. However, AS is not widely utilized, partially due to psychological and decision-making factors associated with treatment preferences.
Methods: In a longitudinal cohort study, we conducted pretreatment telephone interviews (N = 1,140, 69.3% participation) with newly diagnosed, low-risk prostate cancer patients (PSA <= 10, Gleason <= 6) from Kaiser Permanente Northern California. We assessed psychological and decision-making variables, and treatment preference [AS, AT, and No Preference (NP)].
Results: Men were 61.5 (SD, 7.3) years old, 24 days (median) after diagnosis, and 81.1% white. Treatment preferences were: 39.3% AS, 30.9% AT, and 29.7% NP. Multinomial logistic regression revealed that men preferring AS (vs. AT) were older (OR, 1.64; CI, 1.07-2.51), more educated (OR, 2.05; CI, 1.12-3.74), had greater prostate cancer knowledge (OR, 1.77; CI, 1.43-2.18) and greater awareness of having low-risk cancer (OR, 3.97; CI, 1.96-8.06), but also were less certain about their treatment preference (OR, 0.57; CI, 0.41-0.8), had greater prostate cancer anxiety (OR, 1.22; CI, 1.003-1.48), and preferred a shared treatment decision (OR, 2.34; CI, 1.37-3.99). Similarly, men preferring NP (vs. AT) were less certain about treatment preference, preferred a shared decision, and had greater knowledge.
Conclusions: Although a substantial proportion of men preferred AS, this was associated with anxiety and uncertainty, suggesting that this may be a difficult choice.
Impact: Increasing the appropriate use of AS for low-risk prostate cancer will require additional reassurance and information, and reaching men almost immediately after diagnosis while the decision-making is ongoing. (C) 2016 AACR.
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Details
- Title
- Treatment Preferences for Active Surveillance versus Active Treatment among Men with Low-Risk Prostate Cancer
- Creators
- Kathryn L. Taylor - Georgetown University Medical CenterRichard M. Hoffman - Iowa City VA Medical CenterKimberly M. Davis - Georgetown University Medical CenterGeorge Luta - Georgetown University Medical CenterAmethyst Leimpeter - Kaiser PermanenteTania Lobo - Georgetown University Medical CenterScott P. Kelly - Georgetown University Medical CenterJun Shan - Kaiser PermanenteDavid Aaronson - Kaiser PermanenteCatherine A. Tomko - Georgetown University Medical CenterAmy J. Starosta - Georgetown University Medical CenterCharlotte J. Hagerman - Georgetown University Medical CenterStephen K. Van Den Eeden - Kaiser Permanente
- Publication Details
- Cancer epidemiology, biomarkers & prevention, v 25(8), pp 1240-1250
- Publisher
- Amer Assoc Cancer Research
- Number of pages
- 11
- Grant note
- R01 CA 155578-01 / NCI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) R01CA155578 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- WELL Center
- Web of Science ID
- WOS:000383042300007
- Scopus ID
- 2-s2.0-84982958579
- Other Identifier
- 991021862402904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Public, Environmental & Occupational Health