BACKGROUND: Understanding the experiences of men leaving active surveillance programs is critical to making such programs viable for men with localized prostate cancer.
OBJECTIVE: To generate hypotheses about the factors that influence patients' decisions to leave an active surveillance program.
METHODS: Using data from the Johns Hopkins active surveillance cohort, bivariate analyses and multinomial regression models examined characteristics of men who self-elected to leave, those who stayed in the program, and those who left because of disease reclassification. We interviewed patients who self-elected to leave.
RESULTS: Of 1,159 men in active surveillance, 9 % self-elected to leave. In interviews with a sample of 14 men who self-elected to leave, uncertainty involved in active surveillance participation, existence of personal criteria-distinct from providers' clinical criteria-and fear of cancer were important factors in decisions to leave.
CONCLUSION: Men leaving active surveillance were motivated by a number of factors, including patient-defined criteria, which might differ from clinical recommendations. To ensure active surveillance participation, it may be important to address cancer-related anxiety and personal criteria underlying patient decisions.
Written by:
Berger ZD, Yeh JC, Carter HB, Pollack CE. Are you the author?
Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Reference: Patient. 2014 Jun 12. Epub ahead of print.
doi: 10.1007/s40271-014-0066-z
PubMed Abstract
PMID: 24920082
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