In a long-term study of older men diagnosed with low-risk prostate cancer and followed with so-called active surveillance, less than a third of cases eventually needed treatment, according to a new study.
About one half of one percent of the men died of their cancer during up to 18 years of follow-up.
Some prostate cancers do need to be treated on diagnosis, but older men with small, slow-growing cancers may die of other causes - often heart disease - before their prostate cancer shortens their lifespan, the authors note in the Journal of Clinical Oncology.
"Our goal was to make absolutely sure we identified the people that we thought would be the absolute safest," said senior author Dr. H. Ballentine Carter of Johns Hopkins Hospital in Baltimore.
In the U.S., about 30 to 40 percent of men who would qualify for active surveillance for prostate cancer take that option. That proportion that has slowly increased over time but still lags behind other countries, Carter told Reuters Health.
The researchers followed 1,268 men, mostly in their 60s, diagnosed with low-risk or very low-risk prostate cancer in the 2000s.
As part of active surveillance, the men had twice-yearly rectal exams and blood tests for prostate specific antigen (PSA) to measure increases or decreases in the protein produced by the prostate gland. An increase in PSA can signal prostate cancer progression to higher-risk status. The men also had annual prostate biopsies.
Of the whole group, 650 were followed for at least five years and 184 were followed for at least 10 years.
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