Use of Active Surveillance or Watchful Waiting for Low-Risk Prostate Cancer and Management Trends Across Risk Groups in the United States, 2010-2015
Mahal BA, Butler S, Franco I, Spratt DE, Rebbeck TR, D'Amico AV, Nguyen PL
This cancer epidemiology study uses SEER data to examine US trends in use of active surveillance, watchful waiting, radiotherapy, and surgical management of localized prostate cancer among men with low-, intermediate-, and high-risk disease treated between 2010 and 2015.
Historically, most patients with low-risk prostate cancer (clinical category T1c-T2a, prostate-specific antigen level <10 ng/mL, and Gleason 6 disease) were treated with radical prostatectomy, while radiotherapy-based treatment was the favored approach for high-risk localized prostate cancer.1 However, conservative management of low-risk prostate cancer with active surveillance or watchful waiting (AS/WW) offers an alternative to radical prostatectomy or radiotherapy,2 and national guidelines began advocating its use in 2010.3,4 Nevertheless, current AS/WW rates across the United States are not well established, and it is unclear if increasing acceptance of AS/WW for low-risk prostate cancer might be associated with changes in management patterns in higher-risk prostate cancer. Therefore, we examined US trends in management patterns for localized prostate cancer across risk groups.
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