The Role of Active Surveillance in the Management of Early Prostate Cancer and the Impact of the NICE Guidelines

Objective:

The aim of the current study was to assess the implementation of AS in the management of early PC within a typical urology department and determine the impact of the NICE guidelines on this.

Materials and methods:

Three cohorts of 100 patients diagnosed with PC were identified. Patient computer records and hospital notes were used to collect data on diagnosis and management details for each individual.

Management strategies were then assessed and compliance with several key NICE guideline recommendations determined.

Results:

For low risk disease, 92% were offered active surveillance (AS) in 2006, 92% in 2007 and 93% in 2008. Of these 41% of patients in 2006 elected for AS, 61% in 2007 and 72% in 2008. For intermediate risk disease the percentages offered AS were 77% in 2006, 96% in 2007 and 84% in 2008. Of these patients 27%, 38% and 29% of patients elected for AS respectively.

Conclusion:

This study demonstrates that many of the recommendations made were already in practise prior to its publication. It also highlights an increase in the number of men electing for AS and that this trend preceded the guidelines. This increased uptake however, appears limited to low risk disease suggesting better patient awareness.