Prostate cancer is one of the most common cancers found in men in the United States and is a leading cause of cancer-related death. In 2024 alone, nearly 300,000 men in the U.S. are expected to be diagnosed with this disease.
However, not all prostate cancers are the same. Some types grow very slowly and may never cause serious health problems, especially in older men. These low-risk cancers often don’t need treatment right away—or ever.
For many years, the idea of testing all men regularly for prostate cancer using a blood test called PSA (prostate-specific antigen) was debated. The concern was that PSA testing might lead to finding cancers that would never cause harm, but then treating them with surgery or radiation anyway.
These treatments can have side effects, such as problems with urination or sexual function, which are life-changing for many men. Because of this, some health experts believed too many men were being treated for cancers that didn’t need it.
In 2012, the U.S. Preventive Services Task Force recommended against routine PSA screening. They were worried about the harms of overtreatment. In 2018, they changed their advice and said PSA screening could be done, but only after doctors talk with patients about the pros and cons.
Still, many primary care doctors didn’t return to recommending PSA tests, even for men at higher risk, such as African American men or those with a family history of the disease.
Now, new research from the University of Michigan provides encouraging news. Published in JAMA Oncology, the study shows that fewer men with the lowest-risk form of prostate cancer are getting surgery they probably don’t need.
Researchers looked at records from more than 180,000 men who had prostate cancer surgery between 2010 and 2024. They focused on those with Grade Group 1 cancer—the mildest type that is least likely to grow or spread.
These men are usually good candidates for what doctors call “active surveillance.” That means watching the cancer carefully over time with regular PSA tests, scans like MRIs, and occasional biopsies. Treatment is only given if the cancer shows signs of growing or becoming more dangerous.
The researchers found that, across the United States, the number of men with low-risk cancer getting surgery dropped more than five times between 2010 and 2024. In 2010, about 1 in 3 prostate cancer surgeries were done on men with this low-risk type. By 2020, it was less than 1 in 10.
In Michigan, where doctors have been working together to improve care through a program called MUSIC, the drop was even steeper. In 2012, about 1 in 5 men with prostate cancer who had surgery in Michigan had low-risk disease. By 2024, that number fell to fewer than 1 in 35.
Importantly, the improvement was seen across different clinics and hospitals, not just in a few places. This shows that the change is happening on a larger scale. According to Dr. Steven Monda, a urologic cancer researcher and first author of the study, this is a sign of real progress. Doctors and patients are choosing smarter, safer options.
The findings support other research showing that active surveillance is being used more often for men with low-risk prostate cancer. It also suggests that newer, more accurate tools—such as MRI scans and better biopsy techniques—are helping doctors tell which cancers need treatment and which ones can simply be watched.
In summary, this study shows that fewer men are getting surgery for low-risk prostate cancer, and that’s a good thing. It means that more men are avoiding the risks of unnecessary treatment while still being carefully monitored.
This kind of progress may help more men live longer, healthier lives without facing the side effects of surgeries they don’t need. It also supports the idea that when doctors and health systems work together, they can improve care and make better decisions for patients.
If you care about prostate cancer, please read studies about 5 types of bacteria linked to aggressive prostate cancer, and new strategy to treat advanced prostate cancer.
For more information about prostate cancer, please see recent studies about new way to lower risk of prostate cancer spread, and results showing three-drug combo boosts survival in metastatic prostate cancer.
The research findings can be found in JAMA Oncology.
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