Observation Used Often in Young Men with Prostate Cancer

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From 2004 to 2009, marked increase in observation among men with low-risk prostate cancer.
From 2004 to 2009, marked increase in observation among men with low-risk prostate cancer.

Observation is increasingly being used among men with low-risk prostate cancer who are young and healthy enough for treatment, according to a study published in The Journal of Urology.

Chad R. Ritch, M.D., M.B.A., from the University of Miami, and colleagues examined the temporal trend in observation of clinically localized prostate cancer in men who were young and healthy enough to undergo treatment.

Data were included from the Surveillance, Epidemiology, and End Results-Medicare Database for 66,499 men with localized prostate cancer from 2004 to 2009. A predictive model of observation was developed after adjustment for diagnosis year, age, risk, and comorbidity.

The researchers found that observation was performed in 18 percent of men overall, and increased over time from 17 to 20 percent. Among men with low-risk disease, there was a marked increase in observation, from 18 percent in 2004 to 29 percent in 2009.

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The odds of undergoing observation were two-fold higher among men aged 66 to 69 years with low-risk disease and no comorbidities (odds ratio, 2.12). Independent predictors of observation included age, risk group, comorbidity, and race (all P < 0.001), as well as year of diagnosis.

"This suggests growing acceptance of surveillance in this group of patients," the authors write.

Two authors disclosed financial ties to the pharmaceutical and medical device industries.


  1. Ritch, Chad R., et al. "Increasing Use of Observation among Men at Low Risk for Prostate Cancer Mortality." The Journal of Urology. DOI: http://dx.doi.org/10.1016/j.juro.2014.08.102. March 2015.

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