Poor Adherence to Imaging Guidelines for Prostate Cancer
National recommendations often ignored when imaging for staging of prostate cancer
WEDNESDAY, Dec. 21 (HealthDay News) -- Many men with low-risk prostate cancer receive inappropriate imaging for staging of their disease, while a large percentage in the high-risk group go without appropriate imaging, according to research published in the January issue of The Journal of Urology.
Danil V. Makarov, M.D., M.H.S., of the New York University School of Medicine in New York City, and colleagues analyzed data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database for 29,053 men (age range, 66 to 85 years) with prostate cancer diagnosed in 2004 or 2005. Patients were classified to be at high risk or low risk based on 2002 National Comprehensive Cancer Network (NCCN) guidelines.
According to the researchers, 45 percent of the 18,491 low-risk patients received inappropriate imaging, while only 66 percent of the 10,562 high-risk patients received appropriate imaging. Low-risk patients who received inappropriate imaging were more likely to have a higher clinical stage and a higher Gleason score, as well as older age, more comorbidity, and less education. Men at high risk who were imaged appropriately were more likely to have a lower stage of cancer and a higher Gleason score, as well as higher income, white race, younger age, and more comorbidity.
"Our findings reveal poor adherence to the NCCN guidelines, with significant inappropriate imaging in men at low risk and low rates of appropriate imaging in men at high risk," the authors write.