LAS VEGAS--Use of aggressive therapy in elderly prostate cancer patients has increased despite a lack of clear evidence of benefit, Michigan investigators reported at the American Urological Association meeting.
The researchers found that, in metropolitan Detroit, expenditures for aggressive therapy in elderly prostate cancer patients rose 750% in one decade, primarily due to increased use of radiotherapy in these patients.
The conclusions are based on an analysis of data from the Detroit Cancer Surveillance System, a component of the National Cancer Institute's Surveillance Epidemiology and End Result (SEER) program.
The data show double-digit increases between 1973 and 1992 in the use of radical prostatectomy and radiotherapy for localized disease in men over age 75.
Mirroring national trends, the incidence of prostate cancer increased substantially in the period covered by the study. The largest increase in the Detroit area involved men aged 75 to 84, said James Montie, MD, formerly of Wayne State University, Detroit, and currently professor of surgery at the University of Michigan.
From 0.6 to 31.5 per 100,000
From 1973 to 1977, the use of radical prostatectomy for localized disease in men over age 75 averaged 0.6 per 100,000 men over age 75 in the general population (a single procedure during that time period). By 1992, the rate had increased to 31.5 per 100,000 (51 procedures between 1988 and 1992). Use of radiotherapy in the elderly prostate cancer population increased even more during this time frame, from 55 to 605 per 100,000.