He sounds like a great Uro. That is so commendable and rare that he does not rush to biopsy.
I don't know why he had a greater number of newly diagnosed cases this year - the national incidence number is down. The 2016 incidence was 180,890, which is the lowest it's ever been. And prostate cancer mortality hit a new low too:/seer.cancer.gov/statfacts/html/prost.html
It is also cause to celebrate that he is seeing fewer low risk men (I assume he refers all
low risk men for AS). There is indeed a national increase in the proportion
of high risk and advanced cases, but the actual number has been very stable. The proportion increases only because the number of diagnosed low risk men has decreased. While the total number of high-risk plus metastatic cases is pretty steady, their percent of all diagnosed cases has risen from 22% in 2011 (range was 21% to 23% in 2004 to 2011) to 24% in 2012 to 26% in 2013. This is exactly the pattern we hope to see if we have a more rational screening policy — the number
of diagnosed higher-risk cases stays flat while the number of diagnosed favorable-risk cases declines.