Active surveillance
For low-risk prostate cancer, monitoring with PSA, MRI, and repeat biopsy instead of treating, because most such cancers never cause harm.
ProtecT (15-year data, 2023) showed prostate-cancer mortality ~3% regardless of surveillance, surgery, or radiation in PSA-detected disease; ~half of surveillance patients eventually had treatment. Now recommended for essentially all Grade Group 1 and many favourable Grade Group 2 cancers. MRI, PSA density, and genomic classifiers (Decipher, ArteraAI) refine eligibility and triggers.
How it works
Serial PSA, mpMRI, and biopsy; treatment offered on grade or volume progression.
- Avoids incontinence and erectile dysfunction of treatment in men who would never be harmed
- Level-1 evidence of safety (ProtecT)
- Anxiety and adherence
- Repeat biopsies
- Under-used outside high-income countries
Latest papers
topQuery for this technology: (TITLE:"Active surveillance" OR ABSTRACT:"Active surveillance") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Active surveillance, not a curated reading list.
Pages like this
not linked directly; found by shared links- TrialPRECISION
Shares Multiparametric prostate MRI (PI-RADS), Overdiagnosis and false alarms, Prostate cancer.
- TermClinical complete response (cCR)
Shares Organ preservation as the default after complete response in oesophageal cancer, SANO, Oesophageal cancer.
- TermAndrogen deprivation therapy (ADT)
Shares Gleason score and Grade Group, Radical prostatectomy, Prostate cancer.
- TrialCROSS
Shares Organ preservation as the default after complete response in oesophageal cancer, SANO, Oesophageal cancer.
- CompanyVeracyte (Decipher)
Shares Decipher Prostate, Prostate cancer.
- IdeaUltrasound restraint and surveillance to reverse thyroid cancer overdiagnosis
Shares Active surveillance of papillary microcarcinoma, Overdiagnosis and false alarms.
- TermLow-risk differentiated thyroid cancer (ATA risk)
Shares Active surveillance of papillary microcarcinoma, Overdiagnosis and false alarms.
- PairingAI pathology → androgen deprivation duration
Shares ArteraAI Prostate, Prostate cancer.