Discussion

Active surveillance is considered to be a standard management option that is an underutilized approach for reducing the overtreatment of prostate cancer and its associated morbidities. 4, 5 However, the risk of undertreatment on active surveillance remains one deterrent to its increased acceptance in the United States, despite its relatively small impact over a 10-to 15-year period. One recent estimate of undertreatment on active surveillance on the basis of a computer simulation of outcomes from a large active surveillance program demonstrated that, compared with immediate surgical intervention, active surveillance would be associated with a projected decrease in life expectancy of 1.8 months. 6