A study led by the University of Cambridge suggests clinicians consistently overestimate prostate cancer (PCa)-related mortality and the survival benefits of radical treatment.
The study, presented at the European Association of Urology 2019 (EAU19) congress last weekend, surveyed clinicians on PCa prognosis and treatment benefit in a series of case vignettes and compared the findings to estimates using the multivariable prognostic PREDICT model.
Of 190 clinicians who responded to the survey, 121 (63.7%) were urologists and 32 (16.8%) were oncologists. Almost 60 per cent worked in specialist cancer centres and 81.6 per cent reported counselling men with PCa at least weekly. Only 19.3 per cent used any survival prediction tool in their current routine practice.
The study revealed that clinician estimates of 15-year PCa mortality exceeded PREDICT estimates in 92 per cent of cases, with mean clinician estimates of 1.9-fold greater disease lethality than PREDICT.
Clinician perceptions of overall survival benefit from radical treatment at 15 years were over-optimistic, with mean clinician estimates 5.4-fold greater than PREDICT.
Unsurprisingly, concomitantly availability of PREDICT estimates led to reductions in the likelihood of recommending radical treatment in 75 per cent of cases, with reductions most evident in intermediate-risk cases.