Semantics in active surveillance for men with localized prostate cancer — results of a modified Delphi consensus procedure

Semantic heterogeneity exists regarding terminology for active surveillance (AS) for prostate cancer. A panel of leading specialists in prostate cancer and AS involved in the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) consortium participated in a consensus-forming project to reach international consensus on definitions of terms related to this management option. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making. Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if ≥70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.