Table 2 Perceived barriers to a more widespread adoption of active surveillance for Bosniak III-IV cysts (N = 128)
From: Management of complex renal cysts in Canada: results of a survey study
Concerns | Disagree N (%) | Neither agree nor disagree N (%) | Agree N (%) |
|---|---|---|---|
1) Patient and physician concerns regarding the oncologic safety and/or benefits of active surveillance. | 8 (6.3) | 5 (3.9) | 114 (89.8) |
2) The psychological burden for the physicians or patients | 33 (25.8) | 29 (22.7) | 66 (51.6) |
3) The belief that active surveillance is not an appropriate alternative since an effective surgical option already exists. | 43 (33.6) | 31 (24.2) | 54 (42.2) |
4) The lack of data to support active surveillance in patients with BIII-IV | 17 (13.3) | 16 (12.5) | 95 (74.2) |
5) The lack of specific triggers for intervention during active surveillance for cystic tumors | 11 (8.6) | 20 (15.6) | 97 (75.8) |
6) The lack of guidance/knowledge/decision-aid tool on how to best manage and follow patients on active surveillance | 22 (17.2) | 30 (23.4) | 76 (59.4) |
7) The belief that active surveillance is not an efficient trade-off to surgery because it increases the burden of care (i.e., more visits and repeated tests). | 69 (53.9) | 36 (28.1) | 23 (18.0) |
8) The reliability of patients and the possibility of patients being lost to follow-up on active surveillance. | 47 (36.7) | 48 (37.5) | 33 (25.8) |