<p><strong>Clinicians should inform patients undergoing a prostate biopsy that there is a risk of identifying a cancer, with a sufficiently low risk of mortality, that could safely be monitored with AS rather than treated. (<em>Clinical Principle</em>)</strong></p>
Discussion
Discussion
<p>A brief pre-biopsy discussion about pathologic findings warranting AS is expected to increase subsequent acceptance of AS by patients and lower rates of treatment. In a multicenter study of patients undergoing a prostate biopsy, GG1 prostate cancer was found in 44% and 61% of initial and repeat positive biopsies, respectively.<sup>109</sup> For low-risk prostate cancer, AS is the preferred management by the AUA and other international <span>G</span>uidelines.<sup>20</sup> However, a statewide registry from Michigan has documented overtreatment among patients with low-risk prostate cancer and less than a ten-year life expectancy.<sup>110</sup> The primary intent of screening and surveillance is to identify higher-grade cancers that may prompt definitive treatment.</p>