title: Staging practice for prostate cancer varies and is not in line with clinical guidelines.
abstract: The objective was to describe regional variations in M-staging in patients with newly diagnosed prostate cancer within a Danish county and to compare clinical practice with guideline recommendations.
  
  
  
  Data were as captured from 1) a prospective, non-interventional study counting 635 consecutive patients referred for M-staging in the 2008-2009 period at three regional hospitals within one county, and 2) a questionnaire on M-staging practice completed by the five sites performing M-staging in the same county in 2015.
  
  
  
  All three sites referred patients for M-staging in 2008, irrespective of their risk factors. Two of the three sites maintained this practice in 2015. Furthermore, in 2015, three of five sites performed M-staging in intermediate and high-risk patients only. Planar whole-body bone scans were standard in all sites in 2008 with single photon emission computed tomography/computed tomography (SPECT/CT) being performed if required and if available. In 2015, two sites used choline positron emission tomography/CT for primary staging of high-risk patients against guideline recommendations. The use of SPECT/CT showed wide variations from "if required" to "mandatory" head-to-thigh imaging. There were notable variations between clinical practice and guidelines in 2008, and this was even more evident in 2015.
  
  
  
  Considerable variations existed with respect to the M-staging imaging practices in prostate cancer within a single Danish county. The variation was more pronounced in 2015 than in 2008. Clinical practice conflicted in part with European and national Danish guidelines.
  
  
  
  none.
  
  
  
  not relevant.
authors.affiliation: lajp@rn.dk.
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Petersen
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Shuysky
authors.forename: Helle D
authors.initials: HD
authors.lastname: Zacho
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D003718:Denmark; D019983:Guideline Adherence / Q000639:trends; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging / Q000592:standards*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D011795:Surveys and Questionnaires; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D017430:Prostate-Specific Antigen