Increase in conservative management of low-risk prostate cancer

Bottom Line: National guidelines in 2010 began advocating conservative management of low-risk prostate cancer with active surveillance or watchful waiting (AS/WW) as an alternative to radiation to the treat the prostate or surgery to remove the entire prostate. This study examined trends in the management of localized prostate cancer among 165,000 men from 2010 to 2015 using data from a national database of cancer statistics. Use of AS/WW for men with low-risk localized prostate cancer increased from 14.5 percent in 2010 to 42 percent in 2015, becoming the most common management approach. Use of AS/WW increased among men with intermediate-risk disease and remained stable among those with high-risk disease. Surgery to remove the entire prostate declined among men with low-risk disease but increased among patients with higher-risk disease. A limitation of the study is the lack of data on AS/WW compliance.

Authors: Brandon A. Mahal, M.D., Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, and coauthors.

(doi:10.1001/jama.2018.19941)

Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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