Use of active surveillance increasing, active treatment decreasing for low-risk disease
WEDNESDAY, June 29, 2016 (HealthDay News) — From 2011 to 2013 there was a decrease in prostate cancer (PC) diagnoses, especially for younger men and low-risk disease, according to a research letter published online June 23 in JAMA Oncology.
Matthew J. Maurice, M.D., from the Cleveland Clinic, and colleagues identified incident cases of clinically localized PC from 2010 to 2013 to assess current diagnosis and management trends.
The researchers observed a decrease in prostate cancer diagnoses, from a high of 90,419 cases in 2011 to a low of 71,945 cases in 2013. The decrease was seen for all age and risk groups, but was greatest for men younger than 70 years (21 percent decline) and for low-risk disease (36 percent decline). For men of all ages, especially those younger than 70 years, low- and high-risk PC diagnoses decreased significantly over time. There was a significant increase in active surveillance and watchful waiting and a decrease in active treatment for low-risk PC. For high-risk disease, there was a decrease in active treatment use over time, while active surveillance and androgen deprivation therapy increased.
“Low-risk PC is increasingly being managed with active surveillance, which now accounts for nearly 20 percent of cases, demonstrating the feasibility of limiting overtreatment at the patient and provider level,” the authors write. “High-risk PC is being treated less frequently, contrary to level 1 evidence, possibly owing to overtreatment fears incited by the USPSTF.”
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