The trend of conservative treatment for low-risk prostate cancer is increasing


Low-risk prostate cancer has a favourable prognosis without treatment. Current guidelines recommend conservative management or deferring upfront treatment as the preferred approach, but previous studies reported underutilization in the United States compared with other countries.

Among US veterans with low-risk prostate cancer, use of conservative management increased from 2005 to 2015.

The researchers found that of the 59,941 veterans (48%) who received conservative management, 37,717 and 22,224 (30 and 18%), respectively, received watchful waiting and active surveillance. From 2005 to 2015, there was an increase in utilization of conservative management among men aged younger than 65 years (27 to 72%) and among those aged 65 years or older (35 to 79%). The increase was mainly due to more use of active surveillance from 2005 to 2015 (4 to 39% in men aged <65 years and 3 to 41% in men aged ≥65 years).

The utilization of conservative management has increased significantly among US veterans with low-risk prostate cancer, suggesting a substantial reduction in overtreatment during the past decade.


Loeb S, Byrne N, Makarov DV et al. Use of Conservative Management for Low-Risk Prostate Cancer in the Veterans Affairs Integrated Health Care System From 2005-2015. JAMA. 2018;319(21):2231-2233. doi:10.1001/jama.2018.5616

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