Surveillance Becoming More Common for Prostate Cancer
(HealthDay News) — More U.S. physicians are sparing their low-risk prostate cancer patients from prostatectomy, radiation, and androgen deprivation monotherapy in favor of active surveillance/watchful waiting, according to a research letter published in the July 7 issue of the Journal of the American Medical Association.
The researchers found the use of surveillance for low-risk disease to be 7–14% from 1990–2009, but increased to 40% in 2010–2013. This is "excellent news," study author Matthew Cooperberg, MD, MPH, the Helen Diller Family Chair in Urology at the University of California, San Francisco, told HealthDay. "We expected to see a rise in surveillance rates, but were surprised by the steepness of the trajectory," he said. "This really does represent a paradigm change, and it's faster than the typical pace of medical evolution."
Last week, a study published in JAMA Internal Medicine suggested that the wide majority of men with low-risk prostate cancer between 2010–2011 had treatment. But, that study defined low-risk in various ways that included between 11–40% of prostate cancer patients. The new study examines the medical records of 10,472 men from 45 urology practices. And, it uses a single definition of low-risk. The current study also looks at information through 2013.
In addition to finding a higher rate of surveillance in all men, the researchers also found that those aged ≥75 were much less likely to get potentially unnecessary treatment. Among low-risk men aged ≥75, the rate of surveillance rose from 21.9% in 2000–2004 to 76.2% in 2010–2013, the researchers found. As for patients at greater danger, "we're seeing more aggressive management of higher-risk disease with surgery, radiation, or both, which is also a trend toward better management," Cooperberg said.