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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Veterans with low-risk prostate cancer are increasingly skipping surgery and radiation in favor of watchful waiting. A new JAMA study found active surveillance use in the VA healthcare system surged from 27% to 93% for low-risk cases between 2005 and 2024 — far outpacing rates seen in community practices. Experts say more patient education is key to closing that gap nationwide.
Veterans with low-risk prostate cancer are increasingly choosing monitoring over immediate treatment, and the numbers are striking. A new JAMA research letter found that active surveillance use in the VA healthcare system — the nation's largest integrated health system — jumped from 27% to 93% for low-risk prostate cancer between 2005 and 2024. For favorable intermediate-risk disease, rates climbed from 14% to 61% over the same period.
Active surveillance means skipping upfront surgery or radiation and instead closely monitoring the cancer with PSA tests, MRIs, and biopsies — only treating if the disease progresses. Guidelines from NCCN and the American Urological Association already recommend this approach for low-risk cases, but adoption has historically lagged in community settings, where rates topped out around 60% as recently as 2021.
By the numbers:
Why it matters: The VA's integrated structure — with long-term doctor-patient relationships and system-wide quality monitoring — appears to be a model for guideline-concordant care. But racial and ethnic disparities persist even here, and community practice rates still trail far behind, underscoring the need for broader patient education.
