Mahal BA, et al. - In this investigation, researchers studied US trends in management patterns for localized prostate cancer across risk groups. Among 164,760 men, 20,879, 68,350, and 75,531 had active surveillance or watchful waiting (AS/WW), radiotherapy, or radical prostatectomy. AS/WW use increased from 14.5% in 2010 to 42.1% in 2015 among 50,302 men with low-risk disease. On the other hand, radical prostatectomy declined from 47.4% to 31.3% and there was a reduction in radiotherapy from 38.0% to 26.6%. Overall, AS/WW use among men with localized low-risk prostate cancer increased from 2010 to 2015 and became the most common approach to management. Radical prostatectomy in men with low-risk disease decreased; however, it increased in patients with the higher-risk disease. Although increasing AS/WW use for low-risk disease has been supported by high-level evidence and guidelines in recent years, shifting management patterns toward more radical prostatectomy in higher-risk disease and away from radiotherapy does not coincide with any new level 1 evidence or guideline changes.