Evaluating the rates of surgical overtreatment of prostate cancer.

• DOI: 10.1200/jco.2025.43.5_suppl.357
• Publication Date: 2025-02-18T14:38:27Z
• Authors: Steven Monda; Timothy Demus; Sabir Meah; Arnav Srivastava; Richard Sarle; Kevin Ginsburg; Todd Matthew Morgan; Tudor Borza

357 Background: Overtreatment of prostate cancer is a public health concern and barrier to screening. In 2012 the US Preventative Task Force (USPTF) recommended against PSA screening citing overtreatment indolent disease, its associated morbidity, as major limitation safety widespread 2018 USPTF updated their recommendation should only be pursued after an individualized discussion with patient, emphasizing risk overtreatment. We sought evaluate rates surgical over last two decades. Methods: evaluated proportion radical prostatectomies (RP) pathologic Grade Group 1 (pGG1), surrogate for clinically insignificant between 2024 within Michigan Urological Surgery Improvement Collaborative (MUSIC) 2010 2020 Surveillance Epidemiology End Results (SEER) registry. MUSIC served statewide sample focus on urology outcomes, while SEER national sample. Within MUSIC, pGG1, binary variable, was modeled in mixed effects logistic model, time controlling preoperative PSA, age, race, number biopsy cores positive, grade. also assessed these pGG1 RPs higher-risk features: ≥10, >50% or clinical 2 biopsy. Presence any features variable time, age race. Results: Among 23,370 162,558 SEER, decreased periods examined. The patients undergoing RP final pathology from 21% 2.7% 32% 7.8% SEER. independently decrease that were (OR 0.52 per 5-years, 95% CI 0.47-0.57). During periods, ≥10 increased 6.0% 13% 8.1% 10% positive 3.6% 19% 11.8% 15% Time increase had pre-operative 2.25 5 years, 2.07-2.46). Conclusions: rate low-risk has profoundly declined A lower are being performed more likely have features. Proportion pGGG1. 2011 2013 2014 2015 2016 2017 2019 2021 2022 2023 - 18% 16% 12% 8.4% 7.2% 5.5% 5.6% 3.7% 31% 26% 23% 20% 11% 8.8%