Active surveillance for prostate and thyroid cancers: evolution in clinical paradigms and lessons learned

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


The adverse effects of overdiagnosis and overtreatment observed in men with clinically insignificant prostate cancers after the introduction of prostate-specific antigen-based screening are now being observed in those with thyroid cancer, owing to the introduction of new imaging technologies. Thus, the evolving paradigm of active surveillance in prostate and thyroid cancers might be valuable in informing the development of future active surveillance protocols. The lessons learned from active surveillance and their implications include the need to minimize the use of broad, population-based screening programmes that do not incorporate patient education and the need for individualized or shared decision-making, which can decrease the extent of overtreatment. Furthermore, from the experience in patients with prostate cancer, we have learned that consensus is required regarding the optimal selection of patients for active surveillance, using more-specific evidence-based methods for stratifying patients by risk. In this Review, we describe the epidemiology, pathology and screening guidelines for the management of patients with prostate and thyroid cancers; the evidence of overdiagnosis and overtreatment; and provide overviews of existing international active surveillance protocols.

Original languageEnglish (US)
Pages (from-to)168-184
Number of pages17
JournalNature Reviews Clinical Oncology
Issue number3
StatePublished - Mar 1 2019

ASJC Scopus subject areas

  • Oncology

MD Anderson CCSG core facilities

  • Shared Decision Making Core


Dive into the research topics of 'Active surveillance for prostate and thyroid cancers: evolution in clinical paradigms and lessons learned'. Together they form a unique fingerprint.

Cite this