THURSDAY, Nov. 21, 2024 (HealthDay News) -- From 2010 to 2020, there was an increase in the use of active surveillance and watchful waiting for intermediate-risk prostate cancer, according to a research letter published online Nov. 20 in the Journal of the American Medical Association.
Ismail Ajjawi, from the Yale School of Medicine in New Haven, Connecticut, and colleagues examined temporal trends and factors associated with selecting active surveillance and watchful waiting among 147,205 individuals with intermediate-risk prostate cancer diagnosed during 2010 through 2020. Linear time trends in the use of active surveillance and watchful waiting were examined; the analyses were stratified by Gleason grade group (GG) and prostate-specific antigen (PSA) levels.
The researchers found an increase in active surveillance and watchful waiting use from 2010 to 2020 (5.0 to 12.3 percent). Among intermediate-risk patients with GG1, GG2, and GG3, use increased from 13.2 to 53.8 percent, from 4.0 to 11.6 percent, and from 2.5 to 2.8 percent, respectively. From 2010 to 2020, use of active surveillance and watchful waiting increased among intermediate-risk cases with PSA values below 10 ng/mL and for those with PSA values ranging from 10 to 20 ng/mL, from 3.4 to 9.2 percent and from 9.3 to 20.7 percent, respectively. The odds of using active surveillance or watchful waiting were lower in association with higher GGs and increasing PSA values.
"The findings of patients with higher PSAs undergoing active surveillance or watchful waiting more frequently likely stem from a greater proportion of low-grade (GG1) cancer, underscoring that GG remains a highly influential factor in selecting initial management for prostate cancer," the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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