Trends in the use of imaging for patients with newly diagnosed prostate cancer (PCa) indicate a move towards improved value, but computed tomography (CT) and bone scans continue to be ordered inappropriately in low-risk cases while appropriate use in high-risk cases remains inadequate, investigators reported at the Society of Urologic Oncology 2020 virtual annual meeting.
Current guidelines do not recommend CT or bone scans in low-risk PCa, but do recommend regular use in some patients with intermediate-risk disease and all patients with high-risk PCa.
In a study of 2007-2015 data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, Suzanne M. Lange, MD, of the University of Utah in Salt Lake City, Utah, and colleagues found that overall use of imaging remained largely unchanged during the study period and decreased most in patients with low-risk PCa, with CT decreasing from 41.4% to 30.4% and bone scan use decreasing from 36.9% to 11.4%. Use of CT and bone scans for high-risk cases rose slightly during the study period, but these imaging studies were ordered in less than 70% of cases in 2015, according to the investigators. Logistic regression suggested the risk for inappropriate or low-value imaging changed with comorbidity burden and primary treatment types.
“These findings suggest there are different factors driving utilization of imaging between groups, despite the presence [of] professional organization recommendations,” the authors concluded in a study abstract. “Current initiatives to increase the value of imaging appear to be having a modest effect but suggest continued opportunities for meaningful improvement, which may not be the same for every risk group.”
Lange SM, Choudry M, Ambrose J, et al. Updating imaging trends in men with newly diagnosed prostate cancer. Presented at: Society of Urologic Oncology 2020 virtual annual meeting, December 3-5. Poster 158.