Utilization of pre-operative imaging for colon cancer: A population-based study.
OBJECTIVE
To assess the use of pre-operative imaging for colon cancer and to identify factors associated with utilization in routine clinical practice.


METHODS
This population-based, retrospective cohort study used a random sample of 25% of colon cancer patients treated with surgery in the province of Ontario (2002-2008). Pre-operative imaging (<16 weeks from surgery) of the chest, abdomen-pelvis was identified. Modified poisson regression was used to analyze factors associated with practice patterns.


RESULTS
Of the 7,249 included patients, 48% had pre-operative imaging (CT abdomen and imaging of the chest) in keeping with guideline recommendations. The rate of guideline concordant pre-operative imaging increased over time: 64% in the most recent study period (2006-2008) versus 31% (2002-2004); P < 0.001. Variables associated with use of chest imaging: Age, co-morbidity, surgeon volume, and geographic region; no association with gender, hospital volume, or socio-economic status. Variables associated with use of abdomen imaging: Hospital volume and geographic region; no association with age, gender, comorbidity, socio-economic status, or surgeon volume.


CONCLUSIONS
In clinical practice, the majority of patients were not receiving pre-operative imaging that was in line with clinical practice guidelines; however, use increased over time indicating a possible association with dissemination of clinical practice guidelines. J. Surg. Oncol. 2017;115:202-207. © 2016 Wiley Periodicals, Inc.
Department of Radiology, University of Ottawa, Ottawa, ON, Canada.|Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.
Matthew D F
MD
McInnes
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON, Canada.|Department of Oncology, Queen's University, Kingston, ON, Canada.|Department of Surgery, Queen's University, Kingston, ON, Canada.
Sulaiman
S
Nanji
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON, Canada.|Department of Oncology, Queen's University, Kingston, ON, Canada.|Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
William J
WJ
Mackillop
Department of Gastroenterology, Queen's University, Kingston, ON, Canada.
Jennifer A
JA
Flemming
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON, Canada.
Xuejiao
X
Wei
Department of Radiology, University of Ottawa, Ottawa, ON, Canada.|Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.
D Blair
DB
Macdonald
Department of Radiology, University of Ottawa, Ottawa, ON, Canada.|Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.
Nicola
N
Scheida
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON, Canada.|Department of Oncology, Queen's University, Kingston, ON, Canada.|Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
Christopher M
CM
Booth
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
colon cancer; computed tomography; imaging; population-based study