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Research Letter
November 2016

Current Status of Prostate Cancer Diagnosis and Management in the United States

Author Affiliations
  • 1Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
  • 2Urology Institute, University Hospitals Case Medical Center, Cleveland, Ohio
JAMA Oncol. 2016;2(11):1505-1507. doi:10.1001/jamaoncol.2016.1785

In 2012, the US Preventative Services Task Force (USPSTF) recommended against prostate cancer (PC) screening to address overdiagnosis and overtreatment. In response, PC screening and the incidence of localized PC have declined.1 If the USPSTF recommendations were fully implemented, it would eliminate overdiagnosis at the expense of increasing preventable PC deaths.2 Active surveillance also addresses overdiagnosis and, if executed properly, can safely reduce overtreatment by as much as 50%.3 Unlike watchful waiting, which avoids curative treatment entirely, active surveillance involves prospective monitoring of low-risk PC and selective treatment for apparent progression. Prior to the 2012 USPSTF recommendation, active surveillance use was minimal.4 We sought to assess current PC diagnosis and management trends in the United States. The analysis was complete on February 1, 2016. Institutional review board approval was obtained from University Hospitals Case Medical Center prior to study initiation.

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