The number of prostate cancer patients in the U.S. choosing active surveillance over surgery or radiation has rapidly increased since 2010, rising from 16% to 60% for low-risk patients and from 8% to 22% for patients with favorable-intermediate-risk cancers, according to a study published in JAMA Internal Medicine.
It is the preferred treatment option for men with low-risk prostate cancer and an option for favorable intermediate-risk prostate cancer because it mitigates the adverse effects associated with overtreating men with indolent cancer, while remaining oncologically safe.
VUMC researchers, in collaboration with Case Western Reserve University, Weill Cornell Medicine and the National Cancer Institute, studied patients from 2010-2018 and found disparities by race and ethnicity, income and rurality in receiving active surveillance in the U.S.
Hispanic men, men with low income, and men residing in rural areas were less likely to choose or be offered active surveillance.
Study authors used the Surveillance, Epidemiology and End Results (SEER) “Prostate with Watchful Waiting database” to identify men over 40 with low- and favorable intermediate-risk prostate adenocarcinoma from 2010-2018, as defined by the National Comprehensive Care Network.
They reported that a higher number of positive biopsy cores was associated with a higher likelihood of undergoing surgery or radiation, rather than surveillance.
