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Fewer US men are diagnosed with low-risk prostate cancer, and more of them now choose surveillance over treatment

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Fewer US men are diagnosed with low-risk prostate cancer, and more of them now choose surveillance over treatment

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An analysis of United States data reveals a broad shift away from overtreatment of low-risk prostate cancer. The analysis published in CANCER indicates a shift toward surveillance in response to concerns of overdiagnosis and overtreatment that have hindered screening in the recent past.

During the 2010s, recommendations supporting prostate-specific antigen–based screening for prostate cancer wavered due to growing concerns about the use of unnecessary treatment for slow-growing, localized cancers that posed no threat to patients' lives. As a result, guidelines supported active surveillance for such low-risk prostate cancer.

To assess the extent to which this shift has translated into reduced treatment among patients, investigators analyzed localized prostate cancer cases across the U.S. in the Surveillance, Epidemiology, and End Results Program (SEER; 2010–2023), the Veterans Affairs health system (VA; 2010–2024) and the Michigan Radiation Oncology Quality Consortium (MROQC; 2021–2025).

The researchers found that since 2010, low-risk prostate cancer has become less common at the time of diagnosis, while patients diagnosed with low-risk cancer increasingly avoid treatment. Specifically, low-risk prostate cancer at diagnosis declined from 28.8% to 24.0% in SEER and from 32.3% to 21.9% in the VA. Among patients diagnosed with low-risk cancer, receipt of neither radiation nor prostate removal increased from 33.6% to 83.4% in 2023 in SEER and from 51.6% to 96.3% in 2024 in the VA.


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