A recent study reveals that men diagnosed with grade group 1 prostate cancer—a classification often perceived as low risk—may face a broader spectrum of health outcomes than previously understood.
According to research published in JAMA Oncology, up to one in six patients with grade group 1 prostate cancers actually harbor intermediate- or high-risk disease when additional clinical factors are considered beyond biopsy results.
The study highlights a critical distinction between “low grade” and “low risk,” cautioning that relying solely on biopsy grade could underestimate the disease’s severity, potentially leading to undertreatment.
Co-senior author Dr. Jonathan Shoag emphasized that many patients with grade group 1 tumors still carry significant health risks if their cancers go untreated over time.
Researchers analyzed data from over 117,000 men diagnosed with localized grade group 1 prostate cancer between 2010 and 2020 using the National Cancer Institute’s registry.
While 85% showed low-risk disease, about 15% had forms categorized as intermediate or high risk. Among those with high-risk cancer, 60% demonstrated adverse pathology upon prostate removal surgery.
Alarmingly, the study noted that up to 30% of men with these higher-risk grade group 1 tumors were managed with active surveillance, indicating a potential gap in adequate treatment.
Mortality rates for these men, especially those with unfavorable or high-risk disease features, approached rates seen in higher-grade prostate cancers.
These findings underscore the need for better diagnostic approaches to identify aggressive cancers that may initially appear low grade, so patients can receive appropriate care.
Dr. Bashir Al Hussein and Dr. Neal Arvind Patel, co-authors of the study, stressed the importance of understanding the underlying biology of these tumors to improve patient prognosis and avoid harmful undertreatment.
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