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Appraising risk in active surveillance of localized prostate cancer


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Hogden, A ORCID: 0000-0002-4317-7960, Churruca, K, Rapport, F and Gillatt, D 2019 , 'Appraising risk in active surveillance of localized prostate cancer' , Health Expectations, vol. 22, no. 5 , pp. 1028-1039 , doi: 10.1111/hex.12912.

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Objectives: Men diagnosed with low‐risk prostate cancer are typically eligible foractive surveillance of their cancer, involving monitoring for cancer progression andmaking 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 iscommunicated 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 approachwas undertaken, comprising: observations of consultations; patient and clinician in‐terviews; and patient surveys. The three data sets were analysed separately usingthematic analysis and then integrated to give a comprehensive view of patient andclinician views.Results: Thirty data points (eight patient surveys; 10 observations of consultationsbetween patients and clinicians; 10 patient interviews; and two clinician interviews)combined to create a detailed picture of how patients perceived and appraised risk, inthree 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 informationexchange process that identifies patients’ priorities, and details key moments in riskassessment, so that complexities of risk are discussed in ways that are meaningful topatients, may benefit patient care. These findings could inform the development ofpatient‐centric risk assessment procedures and service delivery models in prostatecancer care more broadly.

Item Type: Article
Authors/Creators:Hogden, A and Churruca, K and Rapport, F and Gillatt, D
Keywords: models of care, patient experience, priorities for treatment
Journal or Publication Title: Health Expectations
Publisher: Wiley
ISSN: 1369-6513
DOI / ID Number: 10.1111/hex.12912
Copyright Information:

© 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.

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