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Attitude towards active surveillance: a cross-sectional survey among patients with uroandrological disorders
  1. Paolo Capogrosso1,2,
  2. Luca Boeri1,2,
  3. Eugenio Ventimiglia1,2,
  4. Ilenya Camozzi3,
  5. Walter Cazzaniga1,2,
  6. Francesco Chierigo1,2,
  7. Roberta Scano2,
  8. Alberto Briganti1,2,
  9. Francesco Montorsi1,2,
  10. Andrea Salonia1,2
  1. 1 Urology, Università Vita-Salute San Raffaele, Milan, Italy
  2. 2 Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milano, Italy
  3. 3 Department of Sociology and Social Research, University of Milano-Bicocca, Milan, Italy
  1. Correspondence to Dr Paolo Capogrosso; paolo.capogrosso{at}


Objectives We looked at subjective attitude towards active surveillance (AS) as the first option for cancer management in a cohort of patients seeking first medical help for uroandrological disorders prior to a formal discussion with a caregiver.

Design Cross-sectional observational study.

Setting Uroandrological outpatient clinic of a European academic centre.

Participants Data of 1059 patients at their first access for uroandrological purposes from January 2014 to December 2016 were analysed.

Intervention Patients were invited to complete a survey with closed questions investigating their attitude towards AS, prior to any clinical evaluation. Likewise, patients were invited to score the importance given to different aspects of personal life in the case of a cancer diagnosis, using a 10-point Likert scale.

Primary and secondary outcomes measures The reported opinion towards AS management for cancer was assessed. Logistic regression analyses tested participants’ sociodemographic characteristics associated with a positive opinion on AS.

Results Positive, negative and doubtful attitudes towards AS were observed in 347 (33%), 331 (31%) and 381 (36%) patients, respectively. Female patients were more likely to report a negative attitude towards AS (38.7% vs 29.6%, p=0.04) while patients with previous parenthood more frequently reported a positive opinion on AS (37.2% vs 29.9%, p=0.005). Patient age emerged as the only predictor of a positive attitude towards AS (OR 1.03; 95% CI 1.01 to 1.04, p<0.001), with a 46% and 33% probability of being pro-AS for a patient aged 65 and 45 years, respectively.

Conclusions One out of three patients would express positive feedbacks on AS in the unfortunate case of tumour diagnosis, only according to his/her baseline personal opinion and prior to any discussion with a cancer caregiver. The older the patient, the higher the probability of being compliant with a conservative management for cancer.

  • active surveillance
  • cancer
  • compliance
  • kidney
  • prostate

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  • Contributors PC and AS conceived and designed the study. LB, WC, RS and FC collected the data. IC and AS developed the questionnaire. PC and EV conducted the analysis. FM, AB and AS critically revised the manuscript for important intellectual content. All authors approved the final version prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval IRCCS Ospedale San Raffaele.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors’ licence for using these data precludes the sharing of raw data with third parties.

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