title: Trends in Periodic Surveillance Testing for Early-Stage Uterine Cancer Survivors.
abstract: OBJECTIVE
  To examine the use of periodic surveillance testing for early-stage endometrial cancer survivors.
  
  
  METHODS
  We performed a population-based analysis using the Surveillance, Epidemiology, and End Results-Medicare database, which was used to identify patients with stage I-II endometrioid endometrial cancer treated from 1992 to 2011. Three surveillance periods (7-18, 19-30, 31-42 months) after hysterectomy were examined. Use of vaginal cytology and imaging were quantified.
  
  
  RESULTS
  We identified 17,638 patients. From 1992 to 2011, the use of chest radiography decreased (46.3-34.2%) during the first surveillance period, whereas imaging with chest computed tomography (CT) (0.9-12.6%), abdominopelvic CT (11.7-24.8%), and positron emission tomography (0-2.9%) increased (P<.001 for all). The use of cytology increased from 68.5% in 1992 to 72.3% in 2007 and then decreased to 66.9% in 2011 (P=.02). The mean number of cytologic samples obtained per patient increased from 1.3 in 1992 to 1.6 in 2008 and then declined to 1.3 in 2011, whereas the mean per patient number of chest CTs (0.02-0.2), abdominopelvic CTs (0.2-0.4), and positron emission tomographies (0-0.03) rose from 1992 to 2011. In 2011, 49.3% underwent radiologic surveillance 7-18 months after diagnosis, whereas 11.9% underwent two or more radiologic assessments in combination with cytology. These findings were similar for surveillance periods 2 and 3.
  
  
  CONCLUSIONS
  The use of chest radiography has decreased and use of cytology has started to decline. However, the use of more costly imaging modalities is increasing despite a lack of evidence for the efficacy of these tests for early-stage endometrial cancer survivors.
authors: Departments of Obstetrics and Gynecology and Medicine and the Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, the Department of Epidemiology, Mailman School of Public Health, Columbia University, the Department of Urology, Weill Cornell Medical College, and New York Presbyterian Hospital, New York, New York.
authors: Jason D
authors: JD
authors: Wright
authors: Ana I
authors: AI
authors: Tergas
authors: June Y
authors: JY
authors: Hou
authors: William M
authors: WM
authors: Burke
authors: Yongmei
authors: Y
authors: Huang
authors: Jim C
authors: JC
authors: Hu
authors: Grace Clarke
authors: GC
authors: Hillyer
authors: Cande V
authors: CV
authors: Ananth
authors: Alfred I
authors: AI
authors: Neugut
authors: Dawn L
authors: DL
authors: Hershman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000175:diagnosis*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011159:Population Surveillance / Q000379:methods*; D018426:SEER Program