Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 45 min ago
Peer-reviewedCC BY 4.0Cancer

Population‐level diagnostic and radiation treatment trends of low‐risk prostate cancer

  • Steven M. Monda1
  • Varshini Odayar2
  • Maggie Yin2
  • Rachel Tucker Gonzalez3
  • Salvador Jaime‐Casas1
  • Karolyn M. Hopfensperger2
  • Danielle Kendrick2
  • Melissa A. Mietzel2
  • Mazen Mislmani4
  • Mark Zaki5
  • Patrick W. McLaughlin2,6
  • Todd M. Morgan1
7 more authors
  • William C. Jackson2
  • Matthew J. Schipper2,7
  • David K. Heimburger8
  • Alex K. Bryant3
  • Lori J. Pierce2
  • Tudor Borza1
  • Robert T. Dess2
8 affiliations
  1. 1Department of Urology University of Michigan Ann Arbor Michigan USA
  2. 2Department of Radiation Oncology University of Michigan Ann Arbor Michigan USA
  3. 3VA Ann Arbor Healthcare System Ann Arbor Michigan USA
  4. 4West Michigan Cancer Center Kalamazoo Michigan USA
  5. 5Covenant HealthCare Saginaw Michigan USA
  6. 6Department of Radiation Oncology Assarian Cancer Center Henry Ford Providence Hospital Novi Michigan USA
  7. 7Department of Biostatistics University of Michigan Ann Arbor Michigan USA
  8. 8Munson Healthcare Traverse City Michigan USA
Read full textPDFDOICite

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.

Results: Among localized PC, low‐risk disease at diagnosis declined from 28.8% to 24.0% in SEER and from 32.3% to 21.9% in VA. Among diagnosed low‐risk patients, receipt of neither radiation nor prostatectomy increased from 33.6% to 83.4% in SEER and from 51.6% to 96.3% in VA. Among 207,196 patients treated with radiation for localized PC (170,213 SEER; 34,635 VA; and 2348 MROQC), the proportion with low‐risk disease declined from 33.7% to 6.5% in SEER, from 22.9% to 2.0% in VA, and remained ≤4.2% in MROQC. Declines persisted after adjustment.

Conclusion: Since 2010, low‐risk PC has become less common at diagnosis, whereas diagnosed low‐risk patients increasingly avoid treatment. Radiation for low‐risk PC has markedly declined, paralleling surgical trends and reflecting a nationwide shift toward active surveillance.

Related

  1. Geographic disparities and temporal trends in aggressive prostate cancer: a SEER population-based analysis (2004-2022).
    Yifei Xu, Ayush Singh, Eric Li +7
    Cancer causes & control : CCCPeer-reviewedCC BYFull textOncologyEurope PMC
  2. PSA testing and receipt of curative treatment in elderly Japanese men with prostate cancer: a population-based study.
    Shohei Tobu, Hirokazu Takahashi, Hiroshi Isoda +2
    BMC urologyPeer-reviewedCC BYFull textGeneral medicineEurope PMCDOAJ
  3. Fournier's Gangrene Following Hydrogel Spacer-related Rectal Ulcer and Fistula in a Patient Undergoing Radiation Therapy for Prostate Cancer
    Kazuya Kimura, Kenta Watanabe, Mizuki Kobayashi +18
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textGeneral medicineJ-STAGE
  4. Special Issue: Prostate Cancer Research Update: Molecular Diagnostic Biomarkers
    Mikhail Baryshev
    International Journal of Molecular SciencesPeer-reviewedCC BY 4.0General medicineCrossref
  5. Global burden inequality in lifetime risk of penile, prostate, and testicular cancers: a population-based systematic analysis of GLOBOCAN 2022
    Yile You, Yuhao Li, Qiaorui Wen +5
    BMC Public HealthPeer-reviewedCC BY 4.0Epidemiology & public healthCrossref

Cite

BibTeXRIS
BibTeX
@article{monda2026populationlevel,
  title = {{Population‐level diagnostic and radiation treatment trends of low‐risk prostate cancer}},
  author = {Steven M. Monda and Varshini Odayar and Maggie Yin and Rachel Tucker Gonzalez and Salvador Jaime‐Casas and Karolyn M. Hopfensperger and Danielle Kendrick and Melissa A. Mietzel and Mazen Mislmani and Mark Zaki and Patrick W. McLaughlin and Todd M. Morgan and William C. Jackson and Matthew J. Schipper and David K. Heimburger and Alex K. Bryant and Lori J. Pierce and Tudor Borza and Robert T. Dess},
  journal = {Cancer},
  year = {2026},
  month = oct,
  doi = {10.1002/cncr.70603},
  url = {https://doi.org/10.1002/cncr.70603},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Population‐level diagnostic and radiation treatment trends of low‐risk prostate cancer
AU  - Steven M. Monda
AU  - Varshini Odayar
AU  - Maggie Yin
AU  - Rachel Tucker Gonzalez
AU  - Salvador Jaime‐Casas
AU  - Karolyn M. Hopfensperger
AU  - Danielle Kendrick
AU  - Melissa A. Mietzel
AU  - Mazen Mislmani
AU  - Mark Zaki
AU  - Patrick W. McLaughlin
AU  - Todd M. Morgan
AU  - William C. Jackson
AU  - Matthew J. Schipper
AU  - David K. Heimburger
AU  - Alex K. Bryant
AU  - Lori J. Pierce
AU  - Tudor Borza
AU  - Robert T. Dess
PY  - 2026
DA  - 2026/10/26
JO  - Cancer
DO  - 10.1002/cncr.70603
UR  - https://doi.org/10.1002/cncr.70603
AB  - 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.  Results: Among localized PC, low‐risk disease at diagnosis declined from 28.8% to 24.0% in SEER and from 32.3% to 21.9% in VA. Among diagnosed low‐risk patients, receipt of neither radiation nor prostatectomy increased from 33.6% to 83.4% in SEER and from 51.6% to 96.3% in VA. Among 207,196 patients treated with radiation for localized PC (170,213 SEER; 34,635 VA; and 2348 MROQC), the proportion with low‐risk disease declined from 33.7% to 6.5% in SEER, from 22.9% to 2.0% in VA, and remained ≤4.2% in MROQC. Declines persisted after adjustment.  Conclusion: Since 2010, low‐risk PC has become less common at diagnosis, whereas diagnosed low‐risk patients increasingly avoid treatment. Radiation for low‐risk PC has markedly declined, paralleling surgical trends and reflecting a nationwide shift toward active surveillance.
SN  - 0008-543X
SN  - 1097-0142
ER  -