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Prostate cancer patients are increasingly choosing active surveillance of their symptoms over surgery or radiation, a new study has found.

Active surveillance is a standard option for many patients with either low risk or with favorable, intermediate-risk prostate cancer. Between 2010 and 2018, the number of low-risk patients choosing this option rose from 16% to 60%. Among patients with favorable, intermediate-risk cancers, the numbers rose from 8% to 22% during that time period, investigators reported. 

“The study’s findings are encouraging because it shows an increase in the proportion of men who benefit from active surveillance over time,” Bashir Al Hussein Al Awamlh, MD, of Vanderbilt University in Nashville, TN, said in a statement.

The findings also highlight the growing comfort level with observation among physicians and patients, although there is improvement needed to reach the rate of active surveillance uptake in Europe and Australia, he added.

A boost for PSA tests 

The results may also strengthen arguments that the benefits far outweigh the harms of screening for prostate cancer with the prostate specific antigen (PSA) blood test, said Jonathan Shoag, MD, of Case Western Reserve University in Cleveland. “We now can, and do, avoid treating cancers that we believe will behave indolently.”

The study results also uncovered care disparities. Hispanic men, men with low income and men residing in rural areas were less likely to choose or be offered active surveillance, the authors reported.

Data for patients aged 40 and older came from the Surveillance, Epidemiology and End Results (SEER) “Prostate with Watchful Waiting database.”

Full findings were published in JAMA Internal Medicine.

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