{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T14:40:26Z","timestamp":1793889626853,"version":"4.8.0"},"reference-count":114,"publisher":"American Medical Association (AMA)","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,4,22]]},"abstract":"<jats:sec id=\"ab-jrv250003-1\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Prostate cancer is the most common nonskin cancer in men in the US, with an estimated 299\u202f010 new cases and 35\u202f250 deaths in 2024. Prostate cancer is the second most common cancer in men worldwide, with 1\u202f466\u202f680 new cases and 396\u202f792 deaths in 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jrv250003-2\">\n                    <jats:title>Observations<\/jats:title>\n                    <jats:p>The most common type of prostate cancer is adenocarcinoma (\u226599%), and the median age at diagnosis is 67 years. More than 50% of prostate cancer risk is attributable to genetic factors; older age and Black race (annual incidence rate, 173.0 cases per 100\u202f000 Black men vs 97.1 cases per 100\u202f000 White men) are also strong risk factors. Recent guidelines encourage shared decision-making for prostate-specific antigen (PSA) screening. At diagnosis, approximately 75% of patients have cancer localized to the prostate, which is associated with a 5-year survival rate of nearly 100%. Based on risk stratification that incorporates life expectancy, tumor grade (Gleason score), tumor size, and PSA level, one-third of patients with localized prostate cancer are appropriate for active surveillance with serial PSA measurements, prostate biopsies, or magnetic resonance imaging, and initiation of treatment if the Gleason score or tumor stage increases. For patients with higher-risk disease, radiation therapy or radical prostatectomy are reasonable options; treatment decision-making should include consideration of adverse events and comorbidities. Despite definitive therapy, 2% to 56% of men with localized disease develop distant metastases, depending on tumor risk factors. At presentation, approximately 14% of patients have metastases to regional lymph nodes. An additional 10% of men have distant metastases that are associated with a 5-year survival rate of 37%. Treatment of metastatic prostate cancer primarily relies on androgen deprivation therapy, most commonly through medical castration with gonadotropin-releasing hormone agonists. For patients with newly diagnosed metastatic prostate cancer, the addition of androgen receptor pathway inhibitors (eg, darolutamide, abiraterone) improves survival. Use of abiraterone improved the median overall survival from 36.5 months to 53.3 months (hazard ratio, 0.66 [95% CI, 0.56-0.78]) compared with medical castration alone. Chemotherapy (docetaxel) may be considered, especially for patients with more extensive disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jrv250003-3\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Approximately 1.5 million new cases of prostate cancer are diagnosed annually worldwide. Approximately 75% of patients present with cancer localized to the prostate, which is associated with a 5-year survival rate of nearly 100%. Management includes active surveillance, prostatectomy, or radiation therapy, depending on risk of progression. Approximately 10% of patients present with metastatic prostate cancer, which has a 5-year survival rate of 37%. First-line therapies for metastatic prostate cancer include androgen deprivation and novel androgen receptor pathway inhibitors, and chemotherapy for appropriate patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jama.2025.0228","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T11:00:38Z","timestamp":1741604438000},"page":"1433","source":"Crossref","is-referenced-by-count":416,"title":["Prostate Cancer"],"prefix":"10.1001","volume":"333","author":[{"given":"Ruben","family":"Raychaudhuri","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle"},{"name":"Fred Hutchinson Cancer Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle"},{"name":"Fred Hutchinson Cancer Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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