The use of advanced treatment technologies increased in men diagnosed with prostate cancer (PCa) between 2004 and 2009 who were at low risk of dying from the disease, according to research published in the Journal of the American Medical Association (2013;309:2587-2595).
Bruce L. Jacobs, MD, MPH, of the University of Michigan in Ann Arbor, and colleagues used Surveillance, Epidemiology, and End Results (SEER)-Medicare data to identify men diagnosed with PCa from 2004 to 2009. Data were analyzed for a retrospective cohort of men at low risk of dying from the disease, and men at high risk of dying from a non-cancer cause in the next 10 years, who underwent treatment with advanced or standard treatment technologies such as intensity-modulated radiotherapy (IMRT) versus traditional external beam radiation treatment (EBRT) and robotic prostatectomy versus open radical prostatectomy.
The researchers found significant increases in the use of advanced treatment technologies for 2009 compared with 2004 among men in the cohort with low-risk PCa (32% to 44%), high risk of non-cancer mortality within the next 10 years (36% to 57%), or both (25% to 34%). Among all patients diagnosed with PCa in SEER, the use of advanced treatment technologies among men at low risk for dying from PCa increased significantly, from 13%(129.2 per 1,000 patients) in 2004 to 24% (244.2 per 1,000 patients) in 2009.
“The increasing use of both IMRT and robotic prostatectomy in populations unlikely to benefit from treatment was largely explained by their substitution for the treatments they aim to replace, namely EBRT and open radical prostatectomy,” the authors concluded.