ArticleCancer2020
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Patient-level simulation models in cancer care: a systematic review.Frontiers in public health · 2025Pooled it
- Trial
- Mortality predictors in cancer patients undergoing transcatheter aortic valve implantation for aortic stenosis: a systematic review and meta-analysis.Cardio-oncology (London, England) · 2026Review
- Population-Level Resources and Costs Associated with Low-Risk Prostate Cancer Patients on Active Surveillance.Cancers · 2026Article
- Comparing Multigene Molecular Testing Results of MRI-Target Versus Systematic Prostate Needle Biopsies of Candidates for and Under Active Surveillance.Journal of personalized medicine · 2025Article
- Projected outcomes of reduced-biopsy management of Grade Group 1 prostate cancer: implications for relabeling.Journal of the National Cancer Institute · 2025Article
- Upgrading of Grade Group 1 Prostate Cancer at Prostatectomy: Germline Risk Factors in a Prospective Cohort.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Heme Oxygenase-1 and Prostate Cancer: Function, Regulation, and Implication in Cancer Therapy.International journal of molecular sciences · 2024Review
- Lifetime Health and Economic Outcomes of Biparametric Magnetic Resonance Imaging as First-Line Screening for Prostate Cancer : A Decision Model Analysis.Annals of internal medicine · 2024Article
- Zhoushi Qiling decoction inhibits proliferation of human prostate cancer cells through IL6/STAT3 pathway.Journal of Cancer · 2023Article
- ADAM10-cleaved ephrin-A5 contributes to prostate cancer metastasis.Cell death & disease · 2022Article
- Does Protocol Make a Difference? Comparison of Two Prostate Cancer Active Surveillance Cohorts: A Non-protocol-based Follow-up and a Protocol-based Contemporary Follow-up.European urology open science · 2021Article
- Clarifying the Trade-Offs of Risk-Stratified Screening for Prostate Cancer: A Cost-Effectiveness Study.American journal of epidemiology · 2021Article
- Economic Evaluation of Urine-Based or Magnetic Resonance Imaging Reflex Tests in Men With Intermediate Prostate-Specific Antigen Levels in the United States.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2021Article
- Comprehensive data analysis of genomics, epigenomics, and transcriptomics to identify specific biomolecular markers for prostate adenocarcinoma.Translational andrology and urology · 2021Article
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14 authors at 10 institutions in 3 countries.
Funding
Abstract
backgroundActive surveillance (AS) is an accepted means of managing low-risk prostate cancer. Because of the rarity of downstream events, data from existing AS cohorts cannot yet address how differences in surveillance intensity affect metastasis and mortality. This study projected the comparative benefits of different AS schedules in men diagnosed with prostate cancer who had Gleason score (GS) ≤6 disease and risk profiles similar to those in North American AS cohorts.
methodsTimes of GS upgrading were simulated based on AS data from the University of Toronto, Johns Hopkins University, the University of California at San Francisco, and the Canary Pass Active Surveillance Cohort. Times to metastasis and prostate cancer death, informed by models from the Scandinavian Prostate Cancer Group 4 trial, were projected under biopsy surveillance schedules ranging from watchful waiting to annual biopsies. Outcomes included the risk of metastasis, the risk of death, remaining life-years (LYs), and quality-adjusted LYs.
resultsCompared with watchful waiting, AS biopsies reduced the risk of prostate cancer metastasis and prostate cancer death at 20 years by 1.4% to 3.3% and 1.0% to 2.4%, respectively; and 5-year biopsies reduced the risk of metastasis and prostate cancer death by 1.0% to 2.4% and 0.6% to 1.6%, respectively. There was little difference between annual and 5-year biopsy schedules in terms of LYs (range of differences, 0.04-0.16 LYs) and quality-adjusted LYs (range of differences, -0.02 to 0.09 quality-adjusted LYs).
conclusionsAmong men diagnosed with GS ≤6 prostate cancer, obtaining a biopsy every 3 or 4 years appears to be an acceptable alternative to more frequent biopsies. Reducing surveillance intensity for those who have a low risk of progression reduces the number of biopsies while preserving the benefit of more frequent schedules.
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