Watchful waiting or active surveillance is underused in men with indolent prostate cancer, according to the authors of a study that found radiation therapy was the most common treatment regardless of stage, prostate-specific antigen level, grade, or risk.

The population-based study of 37,261 men with prostate cancer, published in JAMA Oncology, found that the use of watchful waiting or active surveillance increased in men aged over 70, but was significantly lower in men of Asian descent and married men.

Radiation therapy was the most common treatment (57.9%) – followed by radical prostatectomy (19.1% and watching waiting or active surveillance (9.6%) – and its use increased with age, comorbidities, tumor characteristics, and referral to a radiation oncologist (JAMA Oncol. 2015 Feb. 19 [ doi:10.1001/jamaoncol.2014.192 ]).

“Our finding that increased use of radiotherapy among patients with indolent disease portends to a collaborative need for increased dissemination of prostate cancer treatment guidelines among our radiation oncology colleagues,” wrote Dr. Karim Chamie of the University of California, Los Angeles, and coauthors.

The study was supported by the Department of Defense Prostate Cancer Physician Training Award and the National Institutes of Health. No other conflicts of interest were declared.


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