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The rise in screening for prostate cancer during the prostate-specific antigen (PSA) era has led to increased diagnosis of disease and concerns about aggressive treatment of clinically insignificant tumors. Proponents of conservative treatment for localized disease cite the disparity between an estimated 17% lifetime risk for prostate cancer diagnosis and a 3% risk for prostate cancer mortality (according to a Surveillance, Epidemiology, and End Results Cancer Statistics Review, 1975–2004). New studies on conservative management, however, are needed because data on this treatment approach were collected primarily before PSA screening was widely used. To assess the effects of conservative treatment, investigators examined outcomes of 14,516 …