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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.
An examination of patterns of care for prostate cancer are welcome, particularly as there is probably significant underutilization of some treatments and overutilization of others, according to Dr. Sandip M. Prasad and his colleagues.
It is critical to identify predictors of treatment decision making, by both patients and clinicians, as recent studies point to certain nonclinical factors influencing treatment decisions, such as self-referral by urologists to investor-owned facilities. There are concerns that overutilization of expensive treatments may have implications for patient safety, particularly in patients who do not need these treatments.
Dr. Prasadis from the department of urology at the Medical University of South Carolina, Charleston. These comments are taken from an accompanying editorial (JAMA Oncol. 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.183]. There were no conflicts of interest declared.
An examination of patterns of care for prostate cancer are welcome, particularly as there is probably significant underutilization of some treatments and overutilization of others, according to Dr. Sandip M. Prasad and his colleagues.
It is critical to identify predictors of treatment decision making, by both patients and clinicians, as recent studies point to certain nonclinical factors influencing treatment decisions, such as self-referral by urologists to investor-owned facilities. There are concerns that overutilization of expensive treatments may have implications for patient safety, particularly in patients who do not need these treatments.
Dr. Prasadis from the department of urology at the Medical University of South Carolina, Charleston. These comments are taken from an accompanying editorial (JAMA Oncol. 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.183]. There were no conflicts of interest declared.
An examination of patterns of care for prostate cancer are welcome, particularly as there is probably significant underutilization of some treatments and overutilization of others, according to Dr. Sandip M. Prasad and his colleagues.
It is critical to identify predictors of treatment decision making, by both patients and clinicians, as recent studies point to certain nonclinical factors influencing treatment decisions, such as self-referral by urologists to investor-owned facilities. There are concerns that overutilization of expensive treatments may have implications for patient safety, particularly in patients who do not need these treatments.
Dr. Prasadis from the department of urology at the Medical University of South Carolina, Charleston. These comments are taken from an accompanying editorial (JAMA Oncol. 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.183]. There were no conflicts of interest declared.
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.
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.
FROM JAMA ONCOLOGY
Key clinical point: Active surveillance is underused for indolent prostate cancer, and radiotherapy is the most common treatment, regardless of disease stage, severity, or risk.
Major finding: Radiation therapy is used in 57.9% of men with prostate cancer while active surveillance is used in just 9.6%.
Data source: A population-based study of 37,261 men with prostate cancer.
Disclosures: 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.