ArticleBJU international2017
Estimating the risks and benefits of active surveillance protocols for prostate cancer: a microsimulation study.
Article in BJU international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient-level simulation models in cancer care: a systematic review.Frontiers in public health · 2025Pooled it
- Recent incidence and surgery trends for prostate cancer: Towards an attenuation of overdiagnosis and overtreatment?PloS one · 2019Trial
- Personalized Biopsy Schedules Using an Interval-Censored Cause-Specific Joint Model.Statistics in medicine · 2025Article
- Exploring the relation of active surveillance schedules and prostate cancer mortality.Cancer medicine · 2024Article
- Shared decision making of burdensome surveillance tests using personalized schedules and their burden and benefit.Statistics in medicine · 2022Article
- The EU-TOPIA evaluation tool: An online modelling-based tool for informing breast, cervical, and colorectal cancer screening decisions in Europe.Preventive medicine reports · 2021Article
- Personalised biopsy schedules based on risk of Gleason upgrading for patients with low-risk prostate cancer on active surveillance.BJU international · 2021Article
- Personalized Decision Making for Biopsies in Prostate Cancer Active Surveillance Programs.Medical decision making : an international journal of the Society for Medical Decision Making · 2019Article
- Evaluating Parameter Uncertainty in a Simulation Model of Cancer Using Emulators.Medical decision making : an international journal of the Society for Medical Decision Making · 2019Article
- A Tool for Shared Decision Making on Referral for Prostate Biopsy in the Primary Care Setting: Integrating Risks of Cancer with Life Expectancy.Journal of personalized medicine · 2019Article
- Article
- Active surveillance: a review of risk-based, dynamic monitoring.Translational andrology and urology · 2018Review
Corrections and comments
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Authors and funding
3 authors.
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Abstract
objectiveTo estimate the increase in prostate cancer mortality (PCM) and the reduction in overtreatment resulting from different active surveillance (AS) protocols, compared with treating men immediately. PATIENTS AND
methodsWe used a microsimulation model (MISCAN-Prostate), with the natural history of prostate cancer based on European Randomized Study of Screening for Prostate Cancer data. We estimated the probabilities of referral to radical treatment while on AS, depending on disease stage, using data from the Johns Hopkins AS cohort. We sampled 10 million men, representative of the US population, and projected the effects of applying AS protocols that differed by time between biopsies and compared these with the effects of treating men immediately.
resultsWe found that AS with yearly follow-up biopsies for men with low-risk prostate cancer (≤ T2a stage and Gleason 6) increases the probability of PCM to 2.6% (1% increase) and reduces overtreatment from 2.5 to 2.1% (18.4% reduction). With biopsies every 3 years after the first year, PCM increases by 2.3% and overtreatment reduces from 2.5 to 1.9% (30.3% reduction). The inclusion of men in the intermediate-risk group (> T2a stage or Gleason 3+4) in AS protocols increases PCM by 2.7% and reduces overtreatment from 2.5 to 2.0% (23.1% reduction). These results may not apply to African-American men.
conclusionsOffering AS to men with low-risk prostate cancer is relatively safe. Increasing the biopsy interval from yearly to up to every 3 years after the first year will significantly reduce overtreatment among men in the low-risk group, with limited PCM risk.
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