"It pretty much has been adopted around the world so that about 80% of men who are diagnosed with low-risk prostate cancer go on active surveillance. In Sweden, it's about 80%. That's considered the goal. But the United States has been slow in adopting this," says William J. Catalona, MD.
In this video, William J. Catalona, MD, highlights the lag in active surveillance rates seen in the United States. Catalona is a professor of urology at Northwestern University in Chicago, Illinois.
When it started out, it was mainly for old men with a smidgen of low-risk prostate cancer. But it became more popular and more younger and healthier men chose active surveillance. It pretty much has been adopted around the world so that about 80% of men who are diagnosed with low-risk prostate cancer go on active surveillance. In Sweden, it's about 80%. That's considered the goal. But the United States has been slow in adopting this. Before 2010, it was only a very small percentage of patients who were put on active surveillance. Over the years up until the latest paper published on this, it's only about just under 60%. They still would like to bring it up to 80% for the United States. In the studies that have been done, and looking at the science of this, they found that if they look at groups practicing urology, or individual urologists, some of them put 100% of their men on active surveillance and some put 0% on, and you have everything in between. It's human behavior that not every urologist is going to be an angel and put 80% of the men on active surveillance. If all urologists were angels, we wouldn't need these guidelines; they would all do the right thing. The people around the world say this is predominantly United States problem. They say that perhaps some of the American urologists are driven by financial gain by treating everybody with radiation or treating everybody was surgery, even though they have what appears to be a minimal disease.
This transcription has been edited for clarity.