1. The Research Question
1) What is the contemporary prevalence of Active Surveillance (AS) adoption among men newly diagnosed with low-risk localized prostate cancer (LPC)?
2) Are there any racial and/or geographical differences in AS adoption, adherence to AS protocol and switch rates and time to curative treatment over 18 months follow-up?
3) What are the differences in quality-of-life (QOL) measures between the AS group and curative treatment group over the course of 18 months, overall and by race?

2. Research Design and Method
Design: Longitudinal cohort study
Setting: Population-based sample recruited from 2 SEER Cancer Registries (Metro-Detroit & State of Georgia)
Participants:
Black and white men ≤75 years, newly diagnosed ( ) low-risk LPC (PSA<10, Gleason≤6, & stage ≤T2a)
Instrument: Self-administered, mailed survey at:
Baseline (soon after diagnosis)
18 months follow-up (after baseline)
Main Outcome Measure:
Treatment choice
Quality of life

3. What the Research Found
In this population-based sample (~1700), ~55% of patients with low-risk LPC chose observation initially, most chose AS
This represents much higher rate of uptake of AS comparing to % 5 to 10 years ago, even higher than other recent reports from non-population-based cohort 35-45%
Treatment choice was associated with race and geographical location
Black men chose AS less often than white men (p=0.001)
Black men choose radiation more often than white men with this difference being larger in Georgia (p=0.016)
Data collection is ongoing for the 18 month-follow-up of QOL and AS adherence and switch rates and reasons for the switch

4. What this means for Clinical Practice
Our population-based cohort confirmed the recent reports of upward trend of AS adoption among men with newly diagnosed low-risk LPC
This suggests both men and their physicians are more accepting of AS than previously reported
The reasons for the racial and geographical differences in treatment pattern of low-risk LPC deserve more research so that unwanted treatment patterns could be minimized
Comparison data on QOL between AS group and curative treatment group over 18 month-follow-up to be analyzed/announced