Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil
Abstract Background Active surveillance (AS) is the preferred treatment for patients with very low-and low-risk prostate cancer (PCa), but it is underperformed worldwide. This study aimed to report knowledge, attitudes, and practices (KAP) of AS for PCa among urologists in Brazil. Methods This cross...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-022-01036-1 |
| _version_ | 1811341640254619648 |
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| author | Marcelo Langer Wroclawski Breno Santos Amaral Paulo Priante Kayano Wilson Francisco Schreiner Busato Sebastião José Westphal Erik Montagna Bianca Bianco Andrey Soares Fernando Cotait Maluf Gustavo Caserta Lemos Arie Carneiro |
| author_facet | Marcelo Langer Wroclawski Breno Santos Amaral Paulo Priante Kayano Wilson Francisco Schreiner Busato Sebastião José Westphal Erik Montagna Bianca Bianco Andrey Soares Fernando Cotait Maluf Gustavo Caserta Lemos Arie Carneiro |
| author_sort | Marcelo Langer Wroclawski |
| collection | DOAJ |
| description | Abstract Background Active surveillance (AS) is the preferred treatment for patients with very low-and low-risk prostate cancer (PCa), but it is underperformed worldwide. This study aimed to report knowledge, attitudes, and practices (KAP) of AS for PCa among urologists in Brazil. Methods This cross-sectional study used a questionnaire with 50 questions divided into participant characteristics, knowledge regarding inclusion criteria for AS, follow-up, intervention triggers, acceptance, and practice for an index patient. Data analysis comprises absolute and relative frequencies of the variables. After that, a logistic regression was performed in order to verify possible patterns of answers provided by the respondents in the index patient questionnaire. Results Questionnaires were sent through the SurveyMonkey® platform to 5,015 urologists using email addresses and through social media. A total of 600 (12%) questionnaires returned and 413 (8.2%) were completed and included in the analysis. Only 53% of urologists adopt AS for low- and very-low-risk PCa. Inclusion criteria were patients with age > 50 years (32.2%), prostate specific antigen (PSA) < 10 ng/mL (87.2%), T1 clinical stage (80.4%), Biopsy Gleason score ≤ 6, positive cores ≤ 2 (44.3%), positive core involvement < 50% (45.3%), and magnetic resonance imaging findings (38.7%). The PSA doubling time was still used by 60.3%. Confirmatory biopsy (55.9%), PSA level (36.6%), and digital rectal examination (34.4%) were considered by most urologists for follow-ups. Patient preference (85.7%), upgrade of Gleason score (73.4%), and increased number of positive cores (66.8%) were associated with conversion to definitive treatment. In an index patient, non-acceptance and active treatment request were the most cited reasons for not performing AS. Conclusion There is significant variability in the KAP of AS in Brazil, which indicates the need to reinforce AS, its inclusion and follow-up criteria, and the benefits for physicians and the general population. Trial registration : Not applicable. |
| first_indexed | 2024-04-13T18:58:11Z |
| format | Article |
| id | doaj.art-51ab2b16cd874ddabab75e4f09762218 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-13T18:58:11Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-51ab2b16cd874ddabab75e4f097622182022-12-22T02:34:11ZengBMCBMC Urology1471-24902022-06-0122111010.1186/s12894-022-01036-1Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from BrazilMarcelo Langer Wroclawski0Breno Santos Amaral1Paulo Priante Kayano2Wilson Francisco Schreiner Busato3Sebastião José Westphal4Erik Montagna5Bianca Bianco6Andrey Soares7Fernando Cotait Maluf8Gustavo Caserta Lemos9Arie Carneiro10Hospital Israelita Albert EinsteinHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinUniversidade do Vale do Itajaí – UNIVALISociedade Brasileira de UrologiaFaculdade de Medicina do ABCHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinAbstract Background Active surveillance (AS) is the preferred treatment for patients with very low-and low-risk prostate cancer (PCa), but it is underperformed worldwide. This study aimed to report knowledge, attitudes, and practices (KAP) of AS for PCa among urologists in Brazil. Methods This cross-sectional study used a questionnaire with 50 questions divided into participant characteristics, knowledge regarding inclusion criteria for AS, follow-up, intervention triggers, acceptance, and practice for an index patient. Data analysis comprises absolute and relative frequencies of the variables. After that, a logistic regression was performed in order to verify possible patterns of answers provided by the respondents in the index patient questionnaire. Results Questionnaires were sent through the SurveyMonkey® platform to 5,015 urologists using email addresses and through social media. A total of 600 (12%) questionnaires returned and 413 (8.2%) were completed and included in the analysis. Only 53% of urologists adopt AS for low- and very-low-risk PCa. Inclusion criteria were patients with age > 50 years (32.2%), prostate specific antigen (PSA) < 10 ng/mL (87.2%), T1 clinical stage (80.4%), Biopsy Gleason score ≤ 6, positive cores ≤ 2 (44.3%), positive core involvement < 50% (45.3%), and magnetic resonance imaging findings (38.7%). The PSA doubling time was still used by 60.3%. Confirmatory biopsy (55.9%), PSA level (36.6%), and digital rectal examination (34.4%) were considered by most urologists for follow-ups. Patient preference (85.7%), upgrade of Gleason score (73.4%), and increased number of positive cores (66.8%) were associated with conversion to definitive treatment. In an index patient, non-acceptance and active treatment request were the most cited reasons for not performing AS. Conclusion There is significant variability in the KAP of AS in Brazil, which indicates the need to reinforce AS, its inclusion and follow-up criteria, and the benefits for physicians and the general population. Trial registration : Not applicable.https://doi.org/10.1186/s12894-022-01036-1Active surveillanceProstate cancerSurvey |
| spellingShingle | Marcelo Langer Wroclawski Breno Santos Amaral Paulo Priante Kayano Wilson Francisco Schreiner Busato Sebastião José Westphal Erik Montagna Bianca Bianco Andrey Soares Fernando Cotait Maluf Gustavo Caserta Lemos Arie Carneiro Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil BMC Urology Active surveillance Prostate cancer Survey |
| title | Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil |
| title_full | Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil |
| title_fullStr | Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil |
| title_full_unstemmed | Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil |
| title_short | Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil |
| title_sort | knowledge attitudes and practices of active surveillance in prostate cancer among urologists a real life survey from brazil |
| topic | Active surveillance Prostate cancer Survey |
| url | https://doi.org/10.1186/s12894-022-01036-1 |
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