Review of Active Surveillance in Underrepresented and High-Risk Populations: Feasibility and Safety.

IF 2.5 2区医学 Q2 UROLOGY & NEPHROLOGY

Current Urology Reports Pub Date : 2023-07-01 DOI:10.1007/s11934-023-01158-5

John Fastenau, Kunj Jain, Aleksandar Popovic, Evan Kovac

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引用次数: 1

Abstract

Purpose of review: The purpose of this review is to investigate the current use and effectiveness of active surveillance (AS) for clinical low-risk prostate cancer (PCa) in men considered to be "high-risk" based on the factors of race, genetics, healthcare access, and socioeconomic status.

Recent findings: Advances in molecular biomarkers and imaging have improved the detection, risk stratification, and treatment of PCa. Still, overdiagnosis and overtreatment of indolent disease remain a concern. AS is therefore the preferred option for clinical low-risk disease. Yet, because of the variability in PCa presentation based on the aforementioned environmental and genetic factors, the question remains: Is active surveillance a safe option for everyone? Provider hesitancy should not necessarily exclude high-risk men from participating in AS. Rather, clinicians should employ shared decision-making, sound clinical judgment, and stringent follow-up in order to effectively counsel AS candidates and optimize AS-related outcomes in "high-risk" individuals.

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在代表性不足和高危人群中主动监测的综述:可行性和安全性。

综述目的:本综述的目的是调查基于种族、遗传、医疗保健可及性和社会经济地位等因素，对临床低风险前列腺癌(PCa)男性进行主动监测(AS)的现状和有效性。最近发现:分子生物标志物和影像学的进步改善了前列腺癌的检测、风险分层和治疗。尽管如此，对惰性疾病的过度诊断和过度治疗仍然令人担忧。因此，AS是临床低风险疾病的首选。然而，由于基于上述环境和遗传因素的PCa表现的可变性，问题仍然存在:主动监测对每个人都是安全的选择吗?提供者的犹豫不应该排除高风险男性参与AS。相反，临床医生应该采用共同决策、合理的临床判断和严格的随访，以便有效地为AS候选人提供咨询，并优化“高风险”个体的AS相关结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Urology Reports UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

3.80%

发文量

期刊介绍： This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.