Cancer
Population-level diagnostic and radiation treatment trends of low-risk prostate cancer
By Monda SM, Odayar V, Yin M and 16 others.
Abstract
Background
Overtreatment of low-risk prostate cancer (PC) undermines screening efforts. Active surveillance is preferred for low-risk PC, but declining treatment may reflect diagnostic or treatment-selection changes. We assessed diagnostic risk-group trends among localized PC and low-risk trends among radiation-treated patients since 2010.
Methods
We analyzed localized PC in Surveillance, Epidemiology, and End Results Program (SEER; 2010-2023); Veterans Affairs (VA; 2010-2024); and Michigan Radiation Oncology Quality Consortium (MROQC; 2021-2025). Low-risk PC was defined as grade group 1, prostate-specific antigen <10 ng/mL, and clinical stage ≤T2a. Diagnosis-based analyses described risk-group trends among all localized PC diagnoses in SEER and VA and treatment among low-risk patients. The primary outcome was the proportion of radiation-treated patients classified as low-risk, evaluated using logistic regression.