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Related Experiment Video

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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy

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Published on: April 9, 2019

Understanding Active Surveillance for Prostate Cancer.

Lillian Y Lai¹, Vahakn B Shahinian^1,2, Mary K Oerline¹

¹Department of Urology, University of Michigan, Ann Arbor, MI.

JCO Oncology Practice

|April 8, 2021

Summary

Active surveillance for prostate cancer is primarily managed by urologists, but testing and treatment patterns differ significantly across specialties. Further research and guideline development involving multiple specialties are needed.

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Detection and Isolation of Cancer in Prostate Biopsies Using Stimulated Raman Histology and Artificial Intelligence

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Published on: June 10, 2025

Area of Science:

Oncology
Urology
Health Services Research

Background:

Active surveillance is a common management strategy for prostate cancer.
Understanding how different medical specialties manage active surveillance is crucial for optimizing patient care.

Purpose of the Study:

To determine the distribution of active surveillance for prostate cancer across medical specialties.
To analyze variations in testing patterns and treatment transitions based on the managing physician's specialty.

Main Methods:

Analysis of a 20% national sample of Medicare claims (2010-2016) for 13,048 men with prostate cancer initiating surveillance.
Physician specialty assignment based on dominant billing patterns.
Assessment of freedom from treatment and testing frequency by specialty using multinomial logistic regression.

Main Results:

Urologists managed the vast majority of patients (over 93%) on active surveillance.
Testing frequency varied by specialty, with medical oncologists ordering more prostate-specific antigen tests per year than urologists.
Patients managed by radiation oncologists had lower rates of continued surveillance and a higher proportion received radiation therapy compared to other specialties.

Conclusions:

While urologists dominate prostate cancer active surveillance, significant interspecialty variations in testing and treatment exist.
These findings highlight the need for enhanced evidence for surveillance pathways and broader engagement of specialties in guideline development.