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The Impact of a Statewide Active Surveillance Initiative: A Roadmap for Increasing Active Surveillance Utilization

Randy A Vince1, Yilun Sun2, Brandon Mahal3

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

European Urology
|June 10, 2022
PubMed

Insights

Active surveillance (AS) for favorable-risk prostate cancer is underutilized nationally. A quality improvement initiative in Michigan significantly increased AS rates, offering a model for nationwide adoption.

Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • Active surveillance (AS) is recommended for favorable-risk prostate cancer but national uptake is low.
  • Unnecessary treatment for prostate cancer can lead to adverse side effects.

Purpose of the Study:

  • To analyze AS utilization rates in Michigan following a quality improvement (QI) initiative.
  • To compare AS rates in Michigan to national rates for favorable-risk prostate cancer.

Main Methods:

  • Analysis of AS utilization over time in Michigan (MUSIC cohort).
  • Comparison of MUSIC cohort AS rates with national data for favorable-risk prostate cancer patients outside Michigan.

Main Results:

  • AS utilization rates and the rate of increase were significantly higher in the MUSIC cohort compared to the national cohort.
  • The QI initiative demonstrated a substantial positive impact on AS adoption.

Conclusions:

  • The MUSIC QI initiative provides a successful roadmap for increasing AS use nationwide.
  • Implementing similar QI programs can improve management of favorable-risk prostate cancer.
Keywords:
Active surveillanceFavorable riskProstate cancerQuality improvement

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