Why Are Low-Risk Prostate Cancers (Pca) Treated Aggressively? A Population-Based Cohort Analysis.

127Background: Per AUA guidelines, active surveillance (AS) is the best option for very low-risk PCa and preferred for all low-risk patients. However, AS continues to be underused. This study examines decision-making factors in low risk patients. Methods: Using Rapid Case Ascertainment of the North Carolina (NC) Cancer Registry, 1,456 patients were enrolled from 2011-13 across NC soon after diagnosis. NCCN risk group and treatments received (or AS) were determined using medical records and registry data. Phone survey asked patients about their perceived cancer aggressiveness, most important decision-making factor (i.e., cure, quality of life, family burden, cost, daily activity), and desire to be involved in the decision process. Results: Of 585 low-risk patients, 38% pursued AS. Multivariable analysis showed that patient desire to pursue aggressive treatment and perceived cancer aggressiveness were significantly associated with aggressive treatment instead of AS (Table). Further, patients indicating prim...