The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. This work was supported by a Heritage Medical Research Institute/Prostate Cancer Foundation Young Investigator Award (to PN); Joint Center for Radiation Therapy Foundation Grant (to PN); Fitz’s Cancer Warriors (to PN); David and Cynthia Chapin (to PN); and a grant from an anonymous family foundation (to PN).
This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the SEER program tumor registries in the creation of the SEER-Medicare database.
Mariotto AB, Yabroff KR, Shao Y. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst 2011;103:117–128.
van den Bergh RC, Roemeling S, Roobol MJ. Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly. Eur Urol 2009;55:1–8.
Tosoian JJ, Trock BJ, Landis P. Active surveillance program for prostate cancer: an update of the Johns Hopkins experience. J Clin Oncol 2011;29:2185–2190.
Dall’Era MA, Konety BR, Cowan JE. Active surveillance for the management of prostate cancer in a contemporary cohort. Cancer 2008;112:2664–2670.
Wilt TJ, Brawer MK, Jones KM. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 2012;367:203–213.
Moyer VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012;157:120–134.
Mohler JL, Armstrong AJ, Bahnson RR. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Version 1, 2015. Available at: NCCN.org. Accessed April 4, 2014.
Hayes JH, Ollendorf DA, Pearson SD. Active surveillance compared with initial treatment for men with low-risk prostate cancer: a decision analysis. JAMA 2010;304:2373–2380.
Shao YH, Demissie K, Shih W. Contemporary risk profile of prostate cancer in the United States. J Natl Cancer Inst 2009;101:1280–1283.
Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) Research Data (1973-2009), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submission. Available at: http://appliedresearch.cancer.gov/seermedicare/obtain/requests.html.
Warren JL, Klabunde CN, Schrag D. Overview of the SEER-Medicare data: content, research applications, and generalizability to the United States elderly population. Med Care 2002;40(8 Suppl):IV-3–18.
Actuarial Life Table, Year 2007. Social Security Administration. Available at: http://www.ssa.gov/OACT/STATS/table4c6.html. Accessed September 19, 2012.
Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA 2001;285:2750–2756.
Quan H, Sundararajan V, Halfon P. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005;43:1130–1139.
Nguyen PL, Gu X, Lipsitz SR. Cost implications of the rapid adoption of newer technologies for treating prostate cancer. J Clin Oncol 2011;29:1517–1524.
Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005;293:2095–2101.
King CR, McNeal JE, Gill H, Presti JC Jr. Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys 2004;59:386–391.
San Francisco IF, DeWolf WC, Rosen S. Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy. J Urol 2003;169:136–140.
Divrik RT, Eroglu A, Sahin A. Increasing the number of biopsies increases the concordance of Gleason scores of needle biopsies and prostatectomy specimens. Urol Oncol 2007;25:376–382.
Emiliozzi P, Maymone S, Paterno A. Increased accuracy of biopsy Gleason score obtained by extended needle biopsy. J Urol 2004;172(6 Pt 1):2224–2226.
Moussa AS, Kattan MW, Berglund R. A nomogram for predicting upgrading in patients with low- and intermediate-grade prostate cancer in the era of extended prostate sampling. BJU Int 2010;105:352–358.
Sundi D, Ross AE, Humphreys EB. African American men with very low-risk prostate cancer exhibit adverse oncologic outcomes after radical prostatectomy: should active surveillance still be an option for them? J Clin Oncol 2013;31:2991–2997.
D’Amico AV, Manola J, Loffredo M. 6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial. JAMA 2004;292:821–827.
Bolla M, Gonzalez D, Warde P. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med 1997;337:295–300.
Cooperberg MR, Carroll PR, Klotz L. Active surveillance for prostate cancer: progress and promise. J Clin Oncol 2011;29:3669–3676.
Uno H, Nakano M, Ehara H, Deguchi T. Indications for extended 14-core transrectal ultrasound-guided prostate biopsy. Urology 2008;71:23–27.
Bittencourt LK, Barentsz JO, de Miranda LC, Gasparetto EL. Prostate MRI: diffusion-weighted imaging at 1.5T correlates better with prostatectomy Gleason grades than TRUS-guided biopsies in peripheral zone tumours. Eur Radiol 2012;22:468–475.
Freedland SJ, Gerber L, Reid J. Prognostic utility of cell cycle progression score in men with prostate cancer after primary external beam radiation therapy. Int J Radiat Oncol Biol Phys 2013;86:848–853.
Cuzick J, Swanson GP, Fisher G. Prognostic value of an RNA expression signature derived from cell cycle proliferation genes in patients with prostate cancer: a retrospective study. Lancet Oncol 2011;12:245–255.
Knezevic D, Goddard AD, Natraj N. Analytical validation of the Oncotype DX prostate cancer assay—a clinical RT-PCR assay optimized for prostate needle biopsies. BMC Genomics 2013;14:690.
Sanda MG, Dunn RL, Michalski J. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 2008;358:1250–1261.
Jacobs BL, Zhang Y, Schroeck FR. Use of advanced treatment technologies among men at low risk of dying from prostate cancer. JAMA 2013;309:2587–2595.
Klotz L, Zhang L, Lam A. Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer. J Clin Oncol 2010;28:126–131.
2012 Budget Request. National Cancer Institute Web site. Available at: http://www.cancer.gov/aboutnci/budget_planning_leg/plan-2012/2012budgetrequest. Accessed May 2, 2013.
Cooperberg MR, Broering JM, Carroll PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol 2010;28:1117–1123.
Feliu J, Jimenez-Gordo AM, Madero R. Development and validation of a prognostic nomogram for terminally ill cancer patients. J Natl Cancer Inst 2011;103:1613–1620.
Chow E, Davis L, Panzarella T. Accuracy of survival prediction by palliative radiation oncologists. Int J Radiat Oncol Biol Phys 2005;61:870–873.
Froehner M, Koch R, Litz RJ. Which patients are at the highest risk of dying from competing causes </= 10 years after radical prostatectomy? BJU Int 2012;110:206–210.
Fowler FJ Jr, McNaughton Collins M, Albertsen PC. Comparison of recommendations by urologists and radiation oncologists for treatment of clinically localized prostate cancer. JAMA 2000;283:3217–3222.
Aizer AA, Paly JJ, Zietman AL. Multidisciplinary care and pursuit of active surveillance in low-risk prostate cancer. J Clin Oncol 2012;30:3071–3076.
Moore MJ, O’Sullivan B, Tannock IF. How expert physicians would wish to be treated if they had genitourinary cancer. J Clin Oncol 1988;6:1736–1745.
Falit BP, Gross CP, Roberts KB. Integrated prostate cancer centers and over-utilization of IMRT: a close look at fee-for-service medicine in radiation oncology. Int J Radiat Oncol Biol Phys 2010;76:1285–1288.
Mitchell JM, Sunshine JH. Consequences of physicians’ ownership of health care facilities--joint ventures in radiation therapy. N Engl J Med 1992;327:1497–1501.
Anscher MS. Self-referral in radiation oncology: has caveat emptor replaced primum non nocere? Int J Radiat Oncol Biol Phys 2012;84:874.
Anscher MS, Anscher BM, Bradley CJ. The negative impact of stark law exemptions on graduate medical education and health care costs: the example of radiation oncology. Int J Radiat Oncol Biol Phys 2010;76:1289–1294.
Medicare Advantage 2012 Data Spotlight: Enrollment Market Update. The Henry J. Kaiser Family Foundation Web site. Available at: http://www.kff.org/medicare/8323.cfm. Accessed September 23, 2012.