主要针对低风险和中等风险前列腺癌，建议进行积极监测(AS)。不同情境下，AS的应用和实践存在显著差异，监测的体验也不同——检测项目和心理支持水平不同。为了探讨目前AS前列腺癌最佳实践并确定最重要的研究优先事项，采取了一种正式的共识过程，由一组国际专家小组进行，有意参与的的成员涵盖一系列医疗保健专业人员和研究人员，以及前列腺癌的生活经验者。针对从监测到开始治疗的患者旅程开发了关于AS实践和潜在研究优先事项的声明。小组成员在利克特量表上为每个声明进行评分。在小组会议上讨论和重新评分前，组中位数得分和一致性测量结果将呈现给参与者。小组成员确定了目前最佳实践和未来研究优先事项，并最终进行了排名。 共识认为最佳做法包括使用高质量MRI，允许省略数字直肠检查(DRE)，当MRI和前列腺特异性抗原(PSA)动态平稳时，可省略重复标准活检，当PSA或DRE发生变化时，应进MRI ± 活检而不是立即进行积极治疗。最高排名的研究重点是动态风险调整的AS方法，减少对那些进展风险最低的患者的测试。提高监测测试的质量、确保不同患者和情境之间的公平访问和体验，以及改善医生和患者之间和内部的信息和沟通也是高优先事项。局限性包括出于实际原因使用有限的小组成员。 目前AS的最佳实践包括使用高质量MRI排除DRE并作为对PSA变化的首次评估，在PSA和MRI稳定时省略重复标准活检。开发一个强大的、动态的、风险适应性的监测方法是AS前列腺癌最高优先事项。一个包括广泛的医疗保健专业人员和研究人员以及前列腺癌生活经验者在内的多元化专家小组都认同最佳实践包括使用高质量MRI，其可以允许省略数字直肠检查和一些活检。AS研究的最高研究重点是发展一种动态的、风险调整的监测方法。Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Active surveillance (AS) is recommended for low-risk and some intermediate-risk prostate cancer. Uptake and practice of AS vary significantly across different settings, as does the experience of surveillance-from which tests are offered, and to the levels of psychological support.To explore the current best practice and determine the most important research priorities in AS for prostate cancer.A formal consensus process was followed, with an international expert panel of purposively sampled participants across a range of health care professionals and researchers, and those with lived experience of prostate cancer. Statements regarding the practice of AS and potential research priorities spanning the patient journey from surveillance to initiating treatment were developed.Panel members scored each statement on a Likert scale. The group median score and measure of consensus were presented to participants prior to discussion and rescoring at panel meetings. Current best practice and future research priorities were identified, agreed upon, and finally ranked by panel members.There was consensus agreement that best practice includes the use of high-quality magnetic resonance imaging (MRI), which allows digital rectal examination (DRE) to be omitted, that repeat standard biopsy can be omitted when MRI and prostate-specific antigen (PSA) kinetics are stable, and that changes in PSA or DRE should prompt MRI ± biopsy rather than immediate active treatment. The highest ranked research priority was a dynamic, risk-adjusted AS approach, reducing testing for those at the least risk of progression. Improving the tests used in surveillance, ensuring equity of access and experience across different patients and settings, and improving information and communication between and within clinicians and patients were also high priorities. Limitations include the use of a limited number of panel members for practical reasons.The current best practice in AS includes the use of high-quality MRI to avoid DRE and as the first assessment for changes in PSA, with omission of repeat standard biopsy when PSA and MRI are stable. Development of a robust, dynamic, risk-adapted approach to surveillance is the highest research priority in AS for prostate cancer.A diverse group of experts in active surveillance, including a broad range of health care professionals and researchers and those with lived experience of prostate cancer, agreed that best practice includes the use of high-quality magnetic resonance imaging, which can allow digital rectal examination and some biopsies to be omitted. The highest research priority in active surveillance research was identified as the development of a dynamic, risk-adjusted approach.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.