Active Surveillance for Low-Risk Prostate Cancer in Black Patients

Active Surveillance for Low-Risk Prostate Cancer in Black Patients

Authors: Butler S, Muralidhar V, Chavez J, Fullerton Z, Mahal A, Nezolosky M, Vastola M, Zhao SG, D’Amico AV, Dess RT, Feng FY, King MT, Mouw KW, Spratt DE, Trinh Q-D, Nguyen PL, Rebbeck TR, Mahal BA

Conservative management (active surveillance or watchful waiting) for low-risk prostate cancer is an increasingly used alternative to definitive radiation therapy or radical prostatectomy.1,2 Given the underrepresentation of black patients in clinical trials and concern about underlying aggressive disease,3,4 expert panels advise caution when applying conservative management to black patients.1 Therefore, we examined recent trends in the use of active surveillance or watchful waiting in black men, as compared with nonblack men, with low-risk prostate cancer in the United States.

The Surveillance, Epidemiology, and End Results Prostate with Watchful Waiting Database identified patients with low-risk prostate cancer (defined as a clinical stage of T1 to T2a [indicating early-stage disease], a Gleason score of ≤6 [on a scale from 2 to 10, with scores of ≤6 indicating low-risk cancer], and a prostate-specific antigen level of less than 10 ng per milliliter) for which the management type was known and that had been diagnosed between 2010 and 2015.5 Additional details about this cohort and the study design are provided in the Supplementary Appendix, available with the full text of this letter at

We used the Cochran–Armitage test to evaluate trends in initial management over time. Multivariable logistic regression was used to define adjusted odds ratios and 95% confidence intervals for the receipt of active surveillance or watchful waiting as compared with definitive treatment, with race as the primary independent variable. We used the validated Yost index to adjust for socioeconomic status.5 Information regarding all the variables that were included in the models is provided in the Supplementary Appendix...

Read more:

Active Surveillance for Low-Risk Prostat
Download • 150KB

Recent Posts

See All

Handbook for Cancer Research in Africa

Sub-Saharan Africa (SSA) suffers from a growing cancer burden. By the year 2030, cancer and other non-communicable diseases may overtake some infectious diseases as leading causes of death in SSA. Add

MADCaP Network
Dana-Farber Cancer Institute
450 Brookline Avenue
Boston, MA 02215

Supported by Dana-Farber Cancer Institute

MADCaP is grant-funded by the National Cancer Institute

© Copyright 2016-2020 

Dana-Farber Cancer Institute.

Use of MADCaP is subject to our terms of use and our privacy policy.