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In nearly a thousand men with low-risk prostate cancer followed for up to 20 years on active surveillance, only 1.5 percent died of the disease and most never needed treatment, the strongest evidence that surveillance is safe.
Prospective single-centre cohort of 993 men with low-risk (and some favourable intermediate-risk) prostate cancer managed with active surveillance, with treatment triggered by PSA doubling time, grade progression or clinical progression.
At a median follow-up of 6.4 years (up to 20 years), 15 men (1.5 percent) died of prostate cancer and 13 developed metastases; 10- and 15-year cancer-specific survival were 98.1 and 94.3 percent, and about a quarter of men had been treated.
Active surveillance is the preferred management for low-risk prostate cancer, and this cohort's triggers for intervention shaped surveillance protocols worldwide.
The trial that made observation a defensible choice for low-risk prostate cancer found by a blood test, and that supplied the number a man needs when weighing surgery: the progression it prevents is mostly progression on a scan or a blood test, and the harms it causes are felt every day.
The honest state of the overdiagnosis question. Prostate cancer is common in the prostates of men who die of something else, screening finds a proportion of it, and how much of that is harm depends on what is done next. The fix is not a better estimate but fewer treatments for the cancers that do not need them.
The number that anchors the overdiagnosis argument in prostate cancer: over a million American men treated for a cancer that, for most of them, was never going to surface. It is the reason active surveillance exists as a formal pathway and the reason magnetic resonance imaging was brought in front of the biopsy.
Shares PIVOT: follow-up of prostatectomy versus observation for early prostate cancer, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares PIVOT: follow-up of prostatectomy versus observation for early prostate cancer, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatment, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005, Overdiagnosis and overtreatment of prostate cancer, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch.
Shares Overdiagnosis and overtreatment of prostate cancer, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005, PIVOT: follow-up of prostatectomy versus observation for early prostate cancer, Overdiagnosis and overtreatment of prostate cancer, Localised prostate cancer, very low and low risk.
Shares Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Journal of Clinical Oncology, Prostate cancer.