title: Active surveillance for low-risk prostate cancer: knowledge, acceptance and practice among urologists.
abstract: BACKGROUND
  This study aimed to survey urologists regarding their knowledge, acceptance and practice of active surveillance (AS) for low-risk prostate cancer.
  
  
  METHODS
  An email-based survey was distributed to 4987 urologists. Respondents were surveyed regarding their knowledge and acceptance of AS. Those who felt AS was a reasonable strategy were asked their opinions on the criteria for AS enrollment and the details of their practice of AS. Respondents who felt AS was not a reasonable alternative were queried as to the reasons why.
  
  
  RESULTS
  A total of 425 (9%) urologists successfully completed the survey and 387 (91%) were both familiar with AS and aware that AS differed from watchful waiting. Of this latter group, 370 (96%) respondents felt AS was a reasonable management strategy, 95% of whom manage patients with this approach. A minority of respondents (6%) felt that patients with a PSA>10 ng ml(-1) were eligible for AS. Further, most participants (74%) felt that patients required a Gleason score ≤6. There was little agreement on the timing of follow-up biopsies. Respondents who objected to AS were most commonly concerned with missing an opportunity for curative treatment (76%) and the risk of tumor undergrading (65%).
  
  
  CONCLUSIONS
  The majority of participants were knowledgeable and accepting of AS. Respondents were in relative agreement regarding the PSA and Gleason score criteria for AS enrollment. In contrast, there was a lack of agreement on the timing of follow-up biopsies. In the future, comparative studies are required to determine the optimal enrollment criteria and follow-up protocol for patients managed with AS.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Gorin
authors.forename: A
authors.initials: A
authors.lastname: Eldefrawy
authors.forename: O
authors.initials: O
authors.lastname: Ekwenna
authors.forename: M S
authors.initials: MS
authors.lastname: Soloway
mesh_terms: D001707:Biopsy, Needle; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011795:Surveys and Questionnaires; D014572:Urology