You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II1 Apr 2014PD34-10 TRENDS IN MANAGEMENT OF LOW-RISK PROSTATE CANCER IN THE UNITED STATES: A POPULATION-BASED ANALYSIS Adam Weiner, Ruth Etzioni, and Scott Eggener Adam WeinerAdam Weiner More articles by this author , Ruth EtzioniRuth Etzioni More articles by this author , and Scott EggenerScott Eggener More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2435AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-curative initial management (NCIM) for low-risk prostate cancer has good long-term survival but is not commonly used. Our objectives were to measure temporal trends in the proportion of localized prostate cancer patients qualifying for and electing to use NCIM in the United States and analyze the association of factors affecting treatment choice. METHODS Using 2004-2010 data generated by the Surveillance, Epidemiology, and End Results (SEER) Program, we identified all patients diagnosed with localized prostate cancer and measured trends in primary treatment. Low-risk prostate cancer was defined as Gleason ≤ 6, PSA < 10ng/ml, and cT1-cT2a. Logistic regression analyses were used to evaluate determinants of NCIM utilization as well as compare frequencies of Gleason ≤ 6, PSA < 10ng/ml, and cT1-cT2a disease by year. RESULTS We identified 262,595 men diagnosed with localized prostate cancer between 2004 and 2009 with follow-up data through 2010. Of these men, 29% were low-risk. Among low-risk men, 22.8% elected NCIM. Radiation and surgery use declined 8% and 1% respectively while NCIM increased from 19% to 29% (OR 1.81, 95% CI 1.70-1.93, P < 0.001) (Figure). Increased age, decreased PSA, early clinical stage, and recent year of diagnosis were strong determinants of NCIM usage. However, use of NCIM among all localized prostate cancer increased <1%, from 21.4% to 21.9% (OR 1.14, 95% CI 1.10-1.19, P < 0.001). The frequencies of PSA <10 ng/ml and clinical stage T1-T2a disease increased from 73.6% to 78.4% (OR 1.31, 95% CI 1.27-1.55, P < 0.001) and 60.2% to 70.5% (OR 1.58, CI 1.53-1.62, P < 0.001), respectively. The frequency of Gleason ≤ 6 decreased from 54.2% to 43.6% (OR 0.65, 95% CI 0.64-0.67, P < 0.001). CONCLUSIONS Among men with low-risk prostate cancer, increased age, lower PSA, and early clinical stage were associated with a higher likelihood of NCIM. NCIM use has increased among low-risk patients. However, due to an ongoing prostate cancer grade migration resulting in fewer men being classified as low-risk, NCIM use was stable among all localized prostate cancer patients. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e900 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Adam Weiner More articles by this author Ruth Etzioni More articles by this author Scott Eggener More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...