THURSDAY, May 8, 2025 (HealthDay News) -- Some men would rather skip screening for prostate cancer due to fears that they’ll be rendered impotent or incontinent from cancer surgery.

But new research says those fears are unwarranted, thanks to improvements in the way doctors approach prostate cancer.

The number of unnecessary surgeries to treat low-risk prostate cancer has fallen fivefold during the past decade and a half, researchers reported recently in JAMA Oncology.

Prostate removal surgery for what amounted to low-grade cancer declined from 32% in 2010 to just under 8% in 2020, results from a national cancer registry show.

Likewise, a Michigan clinical registry showed a decrease from nearly 21% to about 3% in prostate removals for low-grade cancers between 2012 and 2024, researchers said.

They said this dramatic improvement should bolster men’s confidence that they won’t face any harms from prostate cancer screening.

Doctors are more often opting for active surveillance, in which they monitor the cancer regularly but pursue no treatment until it shows signs of progression, researchers said.

“The decrease in the number of surgeries for low-grade prostate cancer shows that active surveillance helps,” said lead investigator Dr. Steven Monda, a urologic oncology researcher at the University of Michigan.

Improvements in screening and diagnosis also has helped reduce unnecessary surgeries, he added in a news release.

“Routine PSA checks, MRIs and biopsies can ensure that prostate cancer doesn't progress to a condition that requires treatment,” Monda said.

Nearly 300,000 men in the U.S. were expected to be diagnosed with prostate cancer in 2024, researchers said in background notes.

They noted that most prostate cancers grow so slowly they’re unlikely to ever threaten a man’s life, particularly among seniors.

“The discrepancy between how common prostate cancer is and the hesitance in adopting screening exists because, historically, prostate cancer has been considered overtreated,” Monda said.

In many men, prostate cancer requires no treatment, he said. 

“However, in the past, most of these men still underwent surgery or radiation after their diagnosis, which led to hesitance in the widespread adoption of screening,” Monda explained.

Surgery and radiation therapy for prostate cancer surgery can cause men to become impotent or incontinent.

Concerns regarding overtreatment led the U.S. Preventive Services Task Force (USPSTF) in 2012 to recommend against routine PSA screening for prostate cancer, researchers noted.

The task force’s stance softened in 2018 to allow PSA screening after a man had discussed the risks and benefits with his doctor.

“Even though the 2012 USPTF guidelines were revised, many primary care doctors never went back to screening,” senior researcher Dr. Tudor Borza, an assistant professor of urology at the University of Michigan, said in a news release.

“As a result, even people at a higher risk, such as African American men or those with a family history of prostate cancer, aren't being offered screening,” Borza said.

For the new study, researchers analyzed data from more than 180,000 men who underwent prostate cancer surgery between 2010 and 2024.

They focused on the lowest-risk prostate cancers, which provide the best results for active surveillance.

About 1 in every 3 men across the U.S. who underwent prostate cancer surgery had the lowest risk type of cancer in 2010 — an indication that their surgery was unnecessary.

By 2020, that number had dropped to fewer than 1 in 10, results show.

“The results show that this is a system-wide improvement,” Monda said.

More information

The American Cancer Society has more on prostate cancer screening.

SOURCE: University of Michigan, news release, April 30, 2025