Variation in Treatment Recommendations for Low-Risk Prostate Cancer: A Focus on Active Surveillance Across Physician Specialties

Prostate cancer (PC) is the second leading cause of cancer-related death in men globally, with 1 in 8 men in the US diagnosed during their lifetime. For Low-Risk Prostate Cancer (LRPC), management options include Watchful Waiting (WW), Active Surveillance (AS), or curative treatments such as prostatectomy or radiation. While curative treatments can have significant long-term side effects like urinary incontinence and sexual dysfunction, AS is less invasive and preferred due to fewer adverse effects. However, variations in physician training may lead to differing recommendations, potentially causing confusion or frustration for patients consulting multiple specialists. This study investigates whether treatment recommendations—AS, WW, or curative treatment—vary by physician specialty. Using a population-based retrospective design, the study examines 1688 men aged ≤75, diagnosed with LRPC from 2014–2017. Participants self-reported race and completed baseline surveys about treatment options and provider recommendations. Data collection is ongoing, and analysis will focus on differences in treatment recommendation rates by physician specialty. This research aims to clarify how physician specialty influences treatment recommendations for LRPC. Future studies could explore how physician attitudes toward AS, WW, or curative treatments impact their recommendations and further investigate the interaction between physician recommendations and patient race, as racial disparities have been observed in AS recommendations by urologists.