National trends in management of localized prostate cancer: A population based analysis 2004‐2013

Purpose Recent years have brought many changes in the management of localized prostate cancer as national screening guidelines have been updated and diagnostic practice patterns evolved. We sought to better understand how the changing landscape influenced treatment utilization in the United States....

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Bibliographic Details
Published in:The Prostate 2018-05, Vol.78 (7), p.512-520
Main Authors: Chen, Junchao, Oromendia, Clara, Halpern, Joshua A., Ballman, Karla V.
Format: Article
Language:English
Subjects:
Brachytherapy
Cancer surgery
Cancer therapies
Data processing
Diagnosis
expectant management
Management
Patients
Prostate cancer
Prostatectomy
Radiation therapy
radical prostatectomy
radiotherapy
SEER program
Surgery
Urological surgery
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Summary:Purpose Recent years have brought many changes in the management of localized prostate cancer as national screening guidelines have been updated and diagnostic practice patterns evolved. We sought to better understand how the changing landscape influenced treatment utilization in the United States. Methods We used the SEER database in this retrospective analysis of patients with clinically localized prostate cancer between 2004 and 2013. We evaluated utilization of primary treatment modalities over time with descriptive and trend analyses, and examined treatment utilization by cancer risk group and age at diagnosis. Results Of 398 074 patients in the analytic data set, 38% elected radiation therapy, 38% underwent radical prostatectomy, and 24% opted for expectant management. While in 2004 radiation treatment was almost twice as common as expectant management (42% vs 23%), by 2013 approximately equal percentages of patients were treated with each of the three modalities. Expectant management use increased over time, while the proportion of patients opting for surgery decreased remarkably with increasing age at diagnosis in intermediate‐ and higher‐risk disease. Among radiotherapy options, brachytherapy was most common among lower‐risk patients in 2004 but substantially decreased over time (P 
ISSN:0270-4137
1097-0045
DOI:10.1002/pros.23496