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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Active surveillance for low-risk prostate cancer has surged in the VA healthcare system, rising from 27% in 2005 to 93% in 2024 — far outpacing community practices. For favorable intermediate-risk disease, rates climbed from 14% to 61%. But racial and ethnic disparities persist, and experts say better risk stratification is still needed.
The VA healthcare system is setting the gold standard for prostate cancer management. A large cohort study published in JAMA found that among 73,042 male veterans diagnosed with low- or favorable intermediate-risk prostate cancer between 2005 and 2024, active surveillance (AS) use tripled for low-risk disease (27% → 93%) and quadrupled for favorable intermediate-risk disease (14% → 61%) — significantly outpacing rates seen in community-based urology practices across the US.
Researchers credit the VA's integrated structure, long-term physician-patient relationships, and system-level quality monitoring for driving guideline-concordant care. Still, not everything is rosy: Black and Hispanic veterans, as well as those in more socioeconomically deprived areas, had lower odds of receiving AS — a disparity that experts warn could be even more pronounced outside the VA system.
Key Takeaways:
Why it matters: The VA's near-universal adoption of active surveillance for low-risk prostate cancer shows what's possible when systems prioritize evidence-based care. The next challenge is closing equity gaps and refining risk stratification to ensure the right patients are being monitored — not undertreated or overtreated.
