Application of active surveillance in Australia after 2008

A newly published study in BJU International has reported on the application of active surveillance in Australia (and specifically in the state of Victoria) between 2008 and 2012.

Weerakoon et al. used de-identified data from > 6,000 prostate cancer patients in the Victoria Prostate Cancer Registry who were diagnosed between 2008 and August 2012 and for whom follow-up data were available for a minimum of 12 months. The patients were all stratified based on the NCCN risk classification system.

The authors report that:

  • 1,603/6,424 patients (24.9 percent) of men had received no treatment with curative intent at 12 months of follow-up.
    • 980/1,603 patients (61.1 percent) were being managed on active surveillance.
    • 341/1,603 patients (21.3 percent) were being managed on watchful waiting.
    • No management plan was reported for the remainder (282/1,603, 17.6 percent).
  • Of the 980 patients being managed on active surveillance at 12 months after diagnosis
    • 653 patients had very low- or low-risk disease (35.9 percent of a total of 1,816 men with very low- or low-risk disease)
    • 251 patients had intermediate-risk disease (8.9 percent of a total of 2,820 men with intermediate-risk disease)
  • 169/980 patients (17.2 percent) progressed to active treatment after 12 months.
    • 116/169 had a radical prostatectomy.
    • 32/169 had external beam radiation therapy.
    • 12/169 had brachytherapy.
    • 9/169 had androgen deprivation therapy (ADT).
  • Patients were more likely to be managed on active surveillance if they we being treated in the private sector as opposed to under Australia’s public health insurance program.

The fact that about 15 percent of patients in the Victioria Prostate Cancer Registry were being initially managed on active surveillance between 2008 and 2012 seems to suggest a relatively rapid uptake of active surveillance as a primary management option in Victoria over this time frame — although it is harder to understand why this would be more common among private care patients than among those being managed in public care facilities.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: