{"doi":"10.1002/cncr.33911","title":"Treatment in the absence of disease reclassification among men on active surveillance for prostate cancer","abstract":"BACKGROUND: Maintaining men on active surveillance for prostate cancer can be challenging. Although most men who eventually undergo treatment have experienced clinical progression, a smaller subset elects treatment in the absence of disease reclassification. This study sought to understand factors associated with treatment in a large, contemporary, prospective cohort. METHODS: This study identified 1789 men in the Canary Prostate Cancer Active Surveillance Study cohort enrolled as of 2020 with a median follow-up of 5.6 years. Clinical and demographic data as well as information on patient-reported quality of life and urinary symptoms were used in multivariable Cox proportional hazards regression models to identify factors associated with the time to treatment RESULTS: Within 4 years of their diagnosis, 33% of men (95% confidence interval [CI], 30%-35%) underwent treatment, and 10% (95% CI, 9%-12%) were treated in the absence of reclassification. The most significant factor associated with any treatment was an increasing Gleason grade group (adjusted hazard ratio [aHR], 14.5; 95% CI, 11.7-17.9). Urinary quality-of-life scores were associated with treatment without reclassification (aHR comparing \"mostly dissatisfied/terrible\" with \"pleased/mixed,\" 2.65; 95% CI, 1.54-4.59). In a subset analysis (n = 692), married men, compared with single men, were more likely to undergo treatment in the absence of reclassification (aHR, 2.63; 95% CI, 1.04-6.66). CONCLUSIONS: A substantial number of men with prostate cancer undergo treatment in the absence of clinical changes in their cancers, and quality-of-life changes and marital status may be important factors in these decisions. LAY SUMMARY: This analysis of men on active surveillance for prostate cancer shows that approximately 1 in 10 men will decide to be treated within 4 years of their diagnosis even if their cancer is stable. These choices may be related in part to quality-or-life or spousal concerns.","journal":"Cancer","year":2021,"id":200442,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7747,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":778129,"name":"Kehao Zhu","orcid":"0009-0002-6548-4707","position":1,"is_corresponding":false},{"id":420903,"name":"Yingye Zheng","orcid":"0000-0002-3078-4200","position":2,"is_corresponding":false},{"id":715186,"name":"Lisa F. Newcomb","orcid":"0000-0003-3505-3754","position":3,"is_corresponding":false},{"id":347316,"name":"Jeannette M. Schenk","orcid":"0000-0003-4865-7813","position":4,"is_corresponding":false},{"id":1826,"name":"James D. Brooks","orcid":"0000-0003-4521-7505","position":5,"is_corresponding":false},{"id":70071,"name":"Peter R. Carroll","orcid":"0000-0002-1086-4334","position":6,"is_corresponding":false},{"id":431888,"name":"Atreya Dash","orcid":"0000-0002-2634-5539","position":7,"is_corresponding":false},{"id":778772,"name":"William J. Ellis","orcid":null,"position":8,"is_corresponding":false},{"id":451844,"name":"Christopher P. Filson","orcid":"0000-0002-8184-7275","position":9,"is_corresponding":false},{"id":370755,"name":"Martin Gleave","orcid":"0000-0003-4235-0167","position":10,"is_corresponding":false},{"id":374559,"name":"Michael A. Liss","orcid":"0000-0001-6978-1026","position":11,"is_corresponding":false},{"id":778773,"name":"Frances M. Martin","orcid":null,"position":12,"is_corresponding":false},{"id":453227,"name":"Jesse K. McKenney","orcid":"0000-0003-0851-1465","position":13,"is_corresponding":false},{"id":262581,"name":"Todd M. Morgan","orcid":"0000-0002-1140-0603","position":14,"is_corresponding":false},{"id":255746,"name":"Peter S. Nelson","orcid":"0000-0002-5451-5726","position":15,"is_corresponding":false},{"id":420935,"name":"Ian M. Thompson","orcid":"0000-0003-0833-952X","position":16,"is_corresponding":false},{"id":778130,"name":"Andrew A. Wagner","orcid":"0000-0002-1832-1983","position":17,"is_corresponding":false},{"id":404234,"name":"Daniel W. Lin","orcid":"0000-0002-2135-1534","position":18,"is_corresponding":false},{"id":404233,"name":"John L. Gore","orcid":"0000-0002-2847-5062","position":19,"is_corresponding":false},{"id":778128,"name":"Peter S. Kirk","orcid":"0000-0002-1616-4478","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-18T23:50:48.624274Z","pmid":"34516660","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}