A national survey of radiation oncologists and urologists on prediction tools and nomograms for localized prostate cancer

Although prediction tools for prostate cancer (PCa) are essential for high-quality treatment decision-making, little is known about the degree of confidence in existing tools and whether they are used in clinical practice from radiation oncologists (RO) and urologists (URO). Herein, we performed a national survey of specialists about perceived attitudes and use of prediction tools. In 2017, we invited 940 URO and 911 RO in a national survey to query their confidence in and use of the D’Amico criteria, Kattan Nomogram, and CAPRA score. The statistical analysis involved bivariate association and multivariable logistic regression analyses to identify physician characteristics (age, gender, race, practice affiliation, specialty, access to robotic surgery, ownership of linear accelerator and number of prostate cancer per week) associated with survey responses and use of active surveillance (AS) for low-risk PCa. Overall, 691 (37.3%) specialists completed the surveys. Two-thirds (range 65.6–68.4%) of respondents reported being “somewhat confident”, but only a fifth selected “very confident” for each prediction tool (18.0–20.1%). 19.1% of specialists in the survey reported not using any prediction tools in clinical practice, which was higher amongst URO than RO (23.9 vs. 13.4%; p