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AUTHOR REPLY

      The majority of men diagnosed with prostate cancer in the PSA-screening era are eligible for active surveillance and is often the initial therapy in men with low-risk prostate cancer. Active surveillance may reduce unnecessary treatments for patients without increasing risk of prostate cancer mortality.
      • Hamdy FC
      • Donovan JL
      • Lane JA
      • et al.
      10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.
      • Tosoian JJ
      • Mamawala M
      • Epstein JI
      • et al.
      Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer.
      • Klotz L.
      Active surveillance for favorable-risk prostate cancer: who, how and why?.
      However, Black men represented only 7%-13% in these prospective cohort studies. Compared to White men, it has been previously shown that Black men have an increased prostate cancer incidence, higher baseline prostate-specific antigen value, more aggressive prostate cancer features, greater frequency of biochemical recurrence after treatment, and higher overall cancer-specific mortality. Thus, this has given many physicians pause before initiating active surveillance.
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      References

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        Active surveillance for favorable-risk prostate cancer: who, how and why?.
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