Netty Kinsella|Pär Stattin|Declan Cahill|Christian Brown|Anna Bill?Axelson|Ola Bratt|Sigrid Carlsson|Mieke Van Hemelrijck
Factors Influencing Men's Choice of and Adherence to Active Surveillance for Low-risk Prostate Cancer: A Mixed-method Systematic Review
Royal Marsden Hospital|King's College London|Uppsala University|Royal Marsden Hospital|King's College Hospital|Uppsala University|University of Gothenburg|Memorial Sloan Kettering Cancer Center|University of Gothenburg|King's College London|Karolinska Institutet
despite support active surveillance first treatment choice men lowrisk prostate cancer pc strategy largely underutilisedto systematically review barriers facilitators selecting adhering lowrisk pcwe searched psychinfo pubmed medline 2000now embase cinahl cochrane central databases 2002 2017 using preferred reporting items systematic review metaanalysis prisma statement purpose respondents explanation findings significance prefs strengthening reporting observational studies epidemiology strobe quality criteria applied fortyseven studies identifiedkey themes emerged factors influencing choice adherence 1 patient tumour factors age comorbidities knowledge education socioeconomic status family history grade tumour volume fear progressionside effects 2 family social support 3 provider speciality communication attitudes 4 healthcare organisation geography type practice 5 health policy guidelines year awarenessmany factors influence mens choice adherence multiple levels important learn experience chronic health conditions well institutionscountries making significant headway appropriately recruiting men protocols standardised patient information clinician education nationally agreed guidelines ultimately decrease heterogeneity practicewe reviewed scientific literature factors affecting mens choice adherence active surveillance lowrisk prostate cancer findings suggest use could increased addressing variety factors information psychosocial support clinician education standardised guidelines