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Appraising risk in active surveillance of localized prostate cancer


Hogden, A and Churruca, K and Rapport, F and Gillatt, D, Appraising risk in active surveillance of localized prostate cancer, Health Expectations, 22, (5) pp. 1028-1039. ISSN 1369-6513 (2019) [Refereed Article]

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Copyright Statement

© 2019 The Authors Health Expectations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

DOI: doi:10.1111/hex.12912


Objectives: Men diagnosed with low‐risk prostate cancer are typically eligible for active surveillance of their cancer, involving monitoring for cancer progression and making judgements about the risks of prostate cancer against those of active inter‐ vention. Our study examined how risk for prostate cancer is perceived and expe‐ rienced by patients undergoing active surveillance with their clinicians, how risk is communicated in clinical consultations, and the implications for treatment and care.

Method: Participants were nine patients and three clinicians from a university hos‐ pital urology clinic. A staged, qualitative, multi‐method data collection approach was undertaken, comprising: observations of consultations; patient and clinician in‐ terviews; and patient surveys. The three data sets were analysed separately using thematic analysis and then integrated to give a comprehensive view of patient and clinician views.

Results: Thirty data points (eight patient surveys; 10 observations of consultations between patients and clinicians; 10 patient interviews; and two clinician interviews) combined to create a detailed picture of how patients perceived and appraised risk, in three themes of "Making sense of risk", "Talking about risk" and "Responding to risk".

Conclusion: Effective risk communication needs to be finely tuned and timed to in‐ dividual patient's priorities and information requirements. A structured information exchange process that identifies patientsí priorities, and details key moments in risk assessment, so that complexities of risk are discussed in ways that are meaningful to patients, may benefit patient care. These findings could inform the development of patient‐centric risk assessment procedures and service delivery models in prostate cancer care more broadly.

Item Details

Item Type:Refereed Article
Keywords:models of care, patient experience, priorities for treatment
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health informatics and information systems
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Health status (incl. wellbeing)
UTAS Author:Hogden, A (Dr Anne Hogden)
ID Code:136682
Year Published:2019
Web of Science® Times Cited:6
Deposited By:Australian Institute of Health Service Management
Deposited On:2020-01-14
Last Modified:2022-08-29
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