Active Surveillance: Implementation and Adherence to Guidelines

This population-based study from Norway evaluated adherence to national guidelines when enrolling men with newly diagnosed prostate cancer into active surveillance (AS) between 2009 and 2022. Among nearly 70,000 patients, about 16% were managed with AS. Overall, 64% of these cases met guideline criteria, with adherence improving over time from 60% in 2009 to 77% in 2022, particularly after updated guidelines were introduced in 2020. Better adherence was associated with more recent diagnoses, younger patients, better health status, and assessment by private specialists. However, significant regional differences persisted, and about one-third of patients were included in AS without meeting formal criteria. The findings suggest that while AS use has increased, more consistent implementation of guidelines is needed to ensure equitable and evidence-based care across regions.

Scandinavian Journal of Urology 2025, 60,218–225.