An analysis of United States data reveals a broad shift away from overtreatment of low-risk prostate cancer. The analysis published by Wiley online in CANCER , a peer-reviewed journal of the American Cancer Society, indicates a shift toward surveillance in response to concerns of overdiagnosis and overtreatment that have hindered screening in the recent past.
During the 2010s, recommendations supporting prostate-specific antigen–based screening for prostate cancer wavered due to growing concerns about the use of unnecessary treatment for slow-growing, localized cancers that posed no threat to patients’ lives. As a result, guidelines supported active surveillance for such low-risk prostate cancer.
To assess the extent to which this shift has translated into reduced treatment among patients, investigators analyzed localized prostate cancer cases across the U.S. in the Surveillance, Epidemiology, and End Results Program (SEER; 2010–2023), the Veterans Affairs health system (VA; 2010–2024), and the Michigan Radiation Oncology Quality Consortium (MROQC; 2021-2025).
The researchers found that since 2010, low-risk prostate cancer has become less common at the time of diagnosis, while patients diagnosed with low-risk cancer increasingly avoid treatment. Specifically, low-risk prostate cancer at diagnosis declined from 28.8% to 24.0% in SEER and from 32.3% to 21.9% in the VA. Among patients diagnosed with low-risk cancer, receipt of neither radiation nor prostate removal increased from 33.6% to 83.4% in 2023 in SEER and from 51.6% to 96.3% in 2024 in the VA. Among 207,196 patients treated with radiation for localized prostate cancer, the proportion with low-risk disease declined from 33.7% to 6.5% in SEER and from 22.9% to 2.0% in the VA. In the more recent MROQC cohort, the proportion remained low, 2.8% to 4.2%, between 2021 and 2025.
“These data reflect broad changes in how prostate cancer is diagnosed and managed in the United States,” said lead author Steven M. Monda, MD, MSCI, of the University of Michigan. “We are seeing a moderate decline in the amount of low-risk prostate cancer being diagnosed, likely reflecting more magnetic resonance imaging use in screening. Moreso however, we are seeing that most of the low-risk prostate cancer is now being appropriately observed and not treated. This is a big win for patients because it means patients are avoiding the harms of unnecessary treatment for cancers that are unlikely to ever affect them.”
Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com
Full Citation:
“Population-Level Diagnostic and Radiation Treatment Trends of Low-Risk Prostate Cancer.” Steven M. Monda, Varshini Odayar Maggie Yin, Rachel Tucker Gonzalez, Salvador Jaime-Casas, Karolyn M. Hopfensperger, Danielle Kendrick, Melissa A. Mietzel, Mazen Mislmani, Mark Zaki, Patrick W. McLaughlin, Todd M. Morgan, William C. Jackson, Matthew J. Schipper, David K. Heimburger, Alex Bryant, Lori J. Pierce, Tudor Borza, and Robert T. Dess. CANCER ; Published Online: October 26, 2026 (DOI: 10.1002/cncr.70603).
URL Upon Publication : http://doi.wiley.com/10.1002/cncr.70603
Author Contact: Nicole Fawcett, Director of Communications, Michigan Medicine, nfawcett@umich.edu
About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer , and stay up to date with the American Cancer Society Journals on Instagram , LinkedIn , and YouTube .
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Cancer
Population-Level Diagnostic and Radiation Treatment Trends of Low-Risk Prostate Cancer
26-Oct-2026