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Knowledge, attitudes, and practices of active surveillance in prostate cancer among urologists: a real-life survey from Brazil.
Wroclawski, Marcelo Langer; Amaral, Breno Santos; Kayano, Paulo Priante; Busato, Wilson Francisco Schreiner; Westphal, Sebastião José; Montagna, Erik; Bianco, Bianca; Soares, Andrey; Maluf, Fernando Cotait; Lemos, Gustavo Caserta; Carneiro, Arie.
Afiliación
  • Wroclawski ML; Hospital Israelita Albert Einstein, Rua Iguatemi, 192, cj. 43, São Paulo, SP, CEP: 04530-050, Brazil. urologia.marcelo@gmail.com.
  • Amaral BS; BP - A Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil. urologia.marcelo@gmail.com.
  • Kayano PP; Faculdade de Medicina do ABC, Santo Andre, SP, Brazil. urologia.marcelo@gmail.com.
  • Busato WFS; Hospital Israelita Albert Einstein, Rua Iguatemi, 192, cj. 43, São Paulo, SP, CEP: 04530-050, Brazil.
  • Westphal SJ; Hospital Israelita Albert Einstein, Rua Iguatemi, 192, cj. 43, São Paulo, SP, CEP: 04530-050, Brazil.
  • Montagna E; Universidade do Vale do Itajaí - UNIVALI, Itajaí, SC, Brazil.
  • Bianco B; Sociedade Brasileira de Urologia, Rio de Janeiro, RJ, Brazil.
  • Soares A; Faculdade de Medicina do ABC, Santo Andre, SP, Brazil.
  • Maluf FC; Hospital Israelita Albert Einstein, Rua Iguatemi, 192, cj. 43, São Paulo, SP, CEP: 04530-050, Brazil.
  • Lemos GC; Faculdade de Medicina do ABC, Santo Andre, SP, Brazil.
  • Carneiro A; Hospital Israelita Albert Einstein, Rua Iguatemi, 192, cj. 43, São Paulo, SP, CEP: 04530-050, Brazil.
BMC Urol ; 22(1): 86, 2022 Jun 15.
Article en En | MEDLINE | ID: mdl-35706024
BACKGROUND: Active surveillance (AS) is the preferred treatment for patients with very low-and low-risk prostate cancer (PCa), but it is underperformed worldwide. This study aimed to report knowledge, attitudes, and practices (KAP) of AS for PCa among urologists in Brazil. METHODS: This cross-sectional study used a questionnaire with 50 questions divided into participant characteristics, knowledge regarding inclusion criteria for AS, follow-up, intervention triggers, acceptance, and practice for an index patient. Data analysis comprises absolute and relative frequencies of the variables. After that, a logistic regression was performed in order to verify possible patterns of answers provided by the respondents in the index patient questionnaire. RESULTS: Questionnaires were sent through the SurveyMonkey® platform to 5,015 urologists using email addresses and through social media. A total of 600 (12%) questionnaires returned and 413 (8.2%) were completed and included in the analysis. Only 53% of urologists adopt AS for low- and very-low-risk PCa. Inclusion criteria were patients with age > 50 years (32.2%), prostate specific antigen (PSA) < 10 ng/mL (87.2%), T1 clinical stage (80.4%), Biopsy Gleason score ≤ 6, positive cores ≤ 2 (44.3%), positive core involvement < 50% (45.3%), and magnetic resonance imaging findings (38.7%). The PSA doubling time was still used by 60.3%. Confirmatory biopsy (55.9%), PSA level (36.6%), and digital rectal examination (34.4%) were considered by most urologists for follow-ups. Patient preference (85.7%), upgrade of Gleason score (73.4%), and increased number of positive cores (66.8%) were associated with conversion to definitive treatment. In an index patient, non-acceptance and active treatment request were the most cited reasons for not performing AS. CONCLUSION: There is significant variability in the KAP of AS in Brazil, which indicates the need to reinforce AS, its inclusion and follow-up criteria, and the benefits for physicians and the general population. TRIAL REGISTRATION: Not applicable.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Antígeno Prostático Específico Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: BMC Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Brasil

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Antígeno Prostático Específico Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: BMC Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Brasil