Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;82(7):876-879.
doi: 10.1002/pros.24330. Epub 2022 Mar 7.

Comparison of outcomes of different biopsy schedules among men on active surveillance for prostate cancer: An analysis of the G.A.P.3 global consortium database

Kerri R Beckmann  1   2 , Chris H Bangma  3 , Jozien Helleman  3 , Anders Bjartell  4 , Peter R Carroll  5 , Todd Morgan  6 , Daan Nieboer  3 , Aida Santaolalla  2 , Bruce J Trock  7 , Riccardo Valdagni  8 , Monique J Roobol  3 ; Global Action Plan Active Surveillance Prostate Cancer [G.A.P.3] Consortium
Collaborators, Affiliations

Comparison of outcomes of different biopsy schedules among men on active surveillance for prostate cancer: An analysis of the G.A.P.3 global consortium database

Kerri R Beckmann et al. Prostate. 2022 May.

Abstract

Background: The optimal interval for repeat biopsy during active surveillance (AS) for prostate cancer is yet to be defined. This study examined whether risk of upgrading (to grade group ≥ 2) or risk of converting to treatment varied according to intensity of repeat biopsy using data from the GAP3 consortium's global AS database.

Materials and methods: Intensity of surveillance biopsy schedules was categorized according to centers' protocols: (a) Prostate Cancer Research International Active Surveillance project (PRIAS) protocols with biopsies at years 1, 4, and 7 (10 centers; 7532 men); (b) biennial biopsies, that is, every other year (8 centers; 4365 men); and (c) annual biopsy schedules (4 centers; 1602 men). Multivariable Cox regression was used to compare outcomes according to biopsy intensity.

Results: Out of the 13,508 eligible participants, 56% were managed according to PRIAS protocols (biopsies at years 1, 4, and 7), 32% via biennial biopsy, and 12% via annual biopsy. After adjusting for baseline characteristics, risk of converting to treatment was greater for those on annual compared with PRIAS biopsy schedules (hazard ratio [HR] = 1.66; 95% confidence interval [CI] = 1.51-1.83; p < 0.001), while risk of upgrading did not differ (HR = 0.96; 95% CI = 0.84-1.10).

Conclusion: Results suggest more frequent biopsy schedules may deter some men from continuing AS despite no evidence of grade progression.

Keywords: active surveillance; biopsy schedule; prostate cancer; treatment; upgrading.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Bruinsma SM, Roobol MJ, Carroll PR, et al. Expert consensus document: semantics in active surveillance for men with localized prostate cancer – results of a modified Delphi consensus procedure. Nat Rev Urol. 2017;14(5):312‐322. - PubMed
    1. Kinsella N, Helleman J, Bruinsma S, et al. Active surveillance for prostate cancer: a systematic review of contemporary worldwide practices. Transl Androl Urol. 2018;7(1):83‐97. - PMC - PubMed
    1. Shill D. Active surveillance for prostate cancer. Transl Androl Urol. 2021;10:2809‐2819. - PMC - PubMed
    1. Thomsen FB, Brasso K, Klotz LH, Roder MA, Berg KD, Iversen P. Active surveillance for clinically localized prostate cancer—a systematic review. J Surg Oncol. 2014;109(8):830‐835. - PubMed
    1. Beckmann K, Cahill D, Brown C, Van Hemelrijck M, Kinsella N. Understanding reasons for non‐adherence to active surveillance for low‐intermediate risk prostate cancer. Transl Androl Urol. 2021;9:1559‐1565. - PMC - PubMed

Publication types

Substances