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PURPOSE Active surveillance (AS) for prostate cancer (PCa) relies on regular PSA tests and surveillance biopsies. Compliance rates with biopsies vary but the subsequent impact on oncologic outcomes is not known. The objective of this study was to determine whether non-compliance with the confirmatory biopsy negatively impacts PCa-specific outcomes. MATERIAL AND METHODS A retrospective analysis was performed on a prospective single-arm cohort of men enrolled in AS for PCa between 1995 and 2018 with a median follow-up of 9.1 years. A total