Active surveillance—defined as close monitoring without initial treatment—is an established management option for several low-risk, slow-growing cancers. The rationale is that some patients may experience the risks of unnecessary treatment even if the cancer would not progress and become harmful if left untreated. One example is prostate cancer: active surveillance is a frequent management option for localized, low-risk prostate cancer. The proportion of patients choosing this approach in the US increased from 14.5% in 2010 to 42.1% in 2015.1 Another example is low-risk papillary thyroid carcinoma; a recent meta-analysis showed that active surveillance was not associated with an increased risk of recurrence or death.2 Active surveillance for breast ductal carcinoma in situ is being evaluated in clinical trials.3 In this Viewpoint, we propose that active surveillance be evaluated as a management option for select patients with low-risk and asymptomatic basal cell carcinoma. A basal cell carcinoma can be considered low risk if it is smaller than 1 cm in diameter and located on the trunk or extremities and the patient is immunocompetent.
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Linos E, Chren M. Active Surveillance as a Management Option for Low-risk Basal Cell Carcinoma. JAMA Intern Med. 2021;181(8):1032–1033. doi:10.1001/jamainternmed.2021.2643
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