Study: Fewer men undergo unnecessary prostate cancer surgery amid rise in active surveillance

Editor's Note

Prostate cancer surgeries for low-risk patients have plummeted since 2010, signaling major progress in reducing overtreatment, according to an April 29 announcement from the University of Michigan.

University researchers reportedly found that the proportion of men undergoing prostatectomy for Grade Group 1 prostate cancer—the lowest-risk category—dropped more than fivefold between 2010 and 2024.

The study reportedly involved 180,000 men who had prostate cancer surgery during the 14-year period. They found a sharp nationwide decline in surgeries for low-risk cancer: in 2010, one in three prostatectomies involved low-risk cases; by 2020, that figure fell to less than one in ten. In Michigan, where a quality improvement program called MUSIC has emphasized conservative management, the rate dropped from about one in five in 2012 to less than one in 35 by 2024.

Researchers attributed the shift to expanded adoption of active surveillance, an approach where physicians monitor cancer progression with regular PSA checks, MRIs, and biopsies, intervening only if the disease worsens. Improvements in diagnostics and a shift in clinical attitudes have helped men avoid surgeries they may never have needed. However, screening practices remain inconsistent, especially among primary care providers who have not resumed PSA screening even for high-risk groups like African American men and those with a family history.

The full study was published in JAMA Oncology.