SEER database analysis of temporal trends in active surveillance or watchful waiting for intermediate-risk prostate cancer, 2010-2020

A retrospective study using the SEER database investigated temporal trends in use of active surveillance or watchful waiting (AS/WW) for intermediate risk prostate cancer (PrC; defined as biopsy-proven GG2 or GG3; PSA 10-20 ng/ml; or stage cT2b) during 2010 through 2020. Among 147,205 patients with intermediate-risk PrC, use of AS/WW increased from 5.0% in 2010 to 12.3% in 2020 (p<0.001). Use of AS/WW increased from 13.2% to 53.8% among patients with GG1 (p<0.001), from 4.0% to 11.6% among patients with GG2 (p<0.001), and from 2.5% to 2.8% among patients with GG3 (p=0.85); from 3.4% tot 9.2% among intermediate-risk cases with PSA values lower than 10 ng/ml (p<0.001), and from 9.3% to 20.7% among those with PSA values 10-20 ng/ml (p<0.001). In multivariable analysis, higher GGs and increasing PSA values were associated with lower odds of using AS/WW. The authors conclude that the study found a significant increase in use of AS/WW for intermediate-risk PrC between 2010 and 2020.