title: Variation in positron emission tomography use after colon cancer resection.
abstract: OBJECTIVE
  Colon cancer surveillance guidelines do not routinely include positron emission tomography (PET) imaging; however, its use after surgical resection has been increasing. We evaluated the secular patterns of PET use after surgical resection of colon cancer among elderly patients and identified factors associated with its increasing use.
  
  
  METHODS
  We used the SEER-linked Medicare database (July 2001 through December 2009) to establish a retrospective cohort of patients age ≥ 66 years who had undergone surgical resection for colon cancer. Postoperative PET use was assessed with the test for trends. Patient, tumor, and treatment characteristics were analyzed using univariable and multivariable logistic regression analyses.
  
  
  RESULTS
  Of the 39,221 patients with colon cancer, 6,326 (16.1%) had undergone a PET scan within 2 years after surgery. The use rate steadily increased over time. The majority of PET scans had been performed within 2 months after surgery. Among patients who had undergone a PET scan, 3,644 (57.6%) had also undergone preoperative imaging, and 1,977 (54.3%) of these patients had undergone reimaging with PET within 2 months after surgery. Marriage, year of diagnosis, tumor stage, preoperative imaging, postoperative visit to a medical oncologist, and adjuvant chemotherapy were significantly associated with increased PET use.
  
  
  CONCLUSIONS
  PET use after colon cancer resection is steadily increasing, and further study is needed to understand the clinical value and effectiveness of PET scans and the reasons for this departure from guideline-concordant care.
authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Christina E
authors: CE
authors: Bailey
authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Chung-Yuan
authors: CY
authors: Hu
authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Y Nancy
authors: YN
authors: You
authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Harmeet
authors: H
authors: Kaur
authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Randy D
authors: RD
authors: Ernst
authors: University of Texas MD Anderson Cancer Center, Houston, TX gchang@mdanderson.org.
authors: George J
authors: GJ
authors: Chang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003082:Colectomy; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D019983:Guideline Adherence / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D011159:Population Surveillance; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data / Q000639:trends*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018426:SEER Program; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States