Rates of Active Surveillance for Low-Risk Prostate Cancer High for Veterans

TUESDAY, Aug. 18, 2026 (HealthDay News) -- Uptake of active surveillance for low-risk prostate cancer is very high in the Veterans Affairs (VA) health system, according to a research letter published online Aug. 13 in the Journal of the American Medical Association.Grace Lee, M.D., from the San Francisco VA Medical Center, and colleagues evaluated the incidence and quality of active surveillance use in the national VA Healthcare System. The analysis included 73,042 eligible patients with diagnoses (2005 to 2024) of low- and favorable intermediate-risk prostate cancer.The researchers found that 38,130 veterans (52 percent) were treated initially with active surveillance or watchful waiting. For patients with low-risk disease, rates of active surveillance use increased over time (27 to 93 percent), while rates increased from 14 to 61 percent for patients with favorable intermediate-risk disease. Across individual VA facilities, rates of active surveillance ranged from 23 to 93 percent. Older age (odds ratio [OR], 1.43 per decade) and more recent year of diagnosis (OR, 1.21 per year) were associated with increased odds of active surveillance. Decreased odds of active surveillance were seen for Black or African American race (OR, 0.95 versus White), Hispanic or Latino ethnicity (OR, 0.85 versus non-Hispanic), Gleason grade group 2 versus 1 (OR, 0.13), Area Deprivation Index score (OR, 0.97 per quartile), and greater percentage of positive-result biopsy cores (OR, 0.88 per decile)."Prostate cancer care in the VA Healthcare System reflects the best uptake of active surveillance or watchful waiting for favorable-risk disease, suggesting veterans are receiving guideline-based management for favorable-risk prostate cancer," the authors write.Several authors disclosed ties to the pharmaceutical industry.Abstract/Full Text.Sign up for our weekly HealthDay newsletter

Rates of Active Surveillance for Low-Risk Prostate Cancer High for Veterans

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