A new study has found that some men diagnosed with low-grade prostate cancer may actually be at higher risk than their biopsy shows. Researchers from Weill Cornell Medicine, University Hospitals Cleveland, and Case Western Reserve University say that relying only on biopsy results can give an incomplete picture of the disease.
The study, published July 31 in JAMA Oncology, looked at men with “Grade Group one” (GG1) prostate cancer—the lowest grade based on biopsy. It found that one in six of these men actually had more serious cancer when other health data, like PSA levels and tumor size, were also considered.
“We don’t want to miss dangerous cancers that first appear as low-grade,” said Dr. Bashir Al Hussein of Weill Cornell Medicine. “If we underestimate the risk, patients might not get the treatment they really need.”
Calls to Rethink How Doctors Label Low-Grade Cancer
Some doctors have suggested that GG1 tumors shouldn’t be called cancer at all, thinking they are unlikely to cause harm. But this new study challenges that idea.
“People often think low grade means low risk. Our study shows that’s not always true,” said Dr. Jonathan Shoag from Case Western Reserve University. “Some GG1 patients still have a real chance of their cancer growing or spreading.”
National Data Reveals Bigger Picture
The researchers studied data from nearly 300,000 men with prostate cancer in the U.S. between 2010 and 2020. About 117,000 had GG1 based on biopsy. These men are usually monitored with “active surveillance”—regular blood tests, scans, and sometimes repeat biopsies—rather than being treated right away.
But the study found that more than 18,000 of those men actually had higher-risk cancer, which would normally require treatments like surgery or radiation.
“About 30% of the higher-risk men were still being watched under active surveillance,” said Dr. Al Hussein. “That means many may not have received the treatment they needed in time.”
Why This Matters
Biopsies take small samples of the prostate, which can miss more aggressive cancer cells. This study shows that doctors need to look at more than just biopsy results. Adding in other health information can help make sure patients get the right care.
“This is real-world data from across the U.S.,” said Dr. Al Hussein. “It shows we need to be more careful when deciding how to treat so-called low-risk prostate cancer.”
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