Trends in the treatment of localized prostate cancer using supplemented cancer registry data.

Objective: To conduct an analysis of localized prostate cancer treatment in the USA between 1998 and 2002.

Patients And Methods: Results from the National Cancer Institute's Patterns of Care study from 10 regional cancer registries in 1998 and 14 registries in 2002 were compared using univariate and multivariate statistical methods.

Results: Patients with localized prostate cancer in 2002 were younger, had lower prostate-specific antigen values, and higher Gleason scores compared with those diagnosed in 1998. Little change occurred in age-adjusted percentages of men who were treated with a radical prostatectomy (45-46%) or by external beam radiation (EBRT) alone (19-20%). The proportion receiving brachytherapy (BT), alone or with EBRT, increased from 14.9 to 17.7%, while the proportion receiving watchful waiting declined from 12.6 to 9.0%. Younger African-American men with intermediate/high-risk disease were less likely to receive any type of aggressive therapy in comparison with Non-Hispanic White men. Over 70% of men who were ≥ 75 years of age, with low-risk disease, were treated with EBRT or BT.

Conclusions: Older men with low-risk disease might be overtreated with aggressive therapy, while younger intermediate/high-risk African-American men appear less likely to receive indicated aggressive therapy.