Use of Watchful Waiting Up for Low-Risk Localized Prostate Cancer

TUESDAY, Feb. 12, 2019 — From 2010 to 2015, there was an increase in use of active surveillance or watchful waiting (AS/WW) rates in men with low-risk and intermediate-risk localized prostate cancer, according to a research letter published online Feb. 11 in the Journal of the American Medical Association.

Brandon A. Mahal, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues examined U.S. trends in management patterns for localized prostate cancer across risk groups. Data were included for all men with localized prostate cancer diagnosed between 2010 and 2015 with known management type.

The researchers found that 12.7, 41.5, and 45.8 percent of the 164,760 men had AS/WW management, radiotherapy, and radical prostatectomy, respectively. From 2010 to 2015, there was an increase in AS/WW use in men with low-risk disease (14.5 to 42.1 percent), with decreases in radical prostatectomy (47.4 to 31.3 percent) and radiotherapy (38.0 to 26.6 percent). AS/WW use also increased in men with intermediate-risk disease (from 5.8 to 9.6 percent), while decreases were seen in radical prostatectomy (51.8 to 50.6 percent) and radiotherapy (42.4 to 39.8 percent). AS/WW use remained stable in men with high-risk disease (1.9 to 2.2 percent), while there was an increase in radical prostatectomy (38.0 to 42.8 percent) and a decrease in radiotherapy use (60.1 to 55.0 percent).

“The potential downstream effects of efforts to increase AS/WW for men with low-risk disease on management of other risk groups requires further examination,” the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.

Abstract/Full Text

Posted: February 2019

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