Life expectancy is an important consideration that informs the benefits and harms of medical interventions in older adults, especially when the intervention鈥檚 benefits are accrued years later. Life expectancy has been incorporated into guidelines for both screening and treatment of prostate cancer. Men with life expectancy of less than 10 years are not recommended to continue prostate cancer screening nor to receive aggressive treatment for low- to intermediate-risk prostate cancer. The observational study by Daskivich et al,¹ which included 243鈥�928 men in the Veterans Affairs Health System with clinically localized prostate cancer, showed that the rate of prostate cancer overtreatment has actually risen among veterans with limited life expectancy from 2000 to 2019.¹ The study defined overtreatment as aggressive treatment (surgery or radiation) in those with life expectancy less than 10 years and low- to intermediate-risk disease and in those with life expectancy less than 5 years and high-risk disease, in accordance with guideline recommendations. The study found that although there was overall reduction of aggressive treatment in men with low-risk prostate cancer in the active surveillance era, the rate of aggressive treatment increased in men with limited life expectancy, by 22% among men with a life expectancy less than 10 years and intermediate-risk disease and by 29% among men with a life expectancy less than 5 years and high-risk disease. Over three-quarters of the overtreatment was radiation therapy.