Clinical Guidelines May Reduce Unnecessary Prostate Cancer Imaging

Providing clinicians with prostate cancer imaging information and guidelines may help to reduce the amount of inappropriate imaging, suggests a recent study conducted in Sweden.

To reduce national rates of inappropriate prostate cancer imaging, the national Prostate Cancer Register of Sweden has supplied urologists with imaging guidelines and utilization data since 2000. The study, published online on July 13, 2013, in the Journal of the National Cancer Institute, analyzed the effects of this campaign on prostate cancer imaging rates in 99,879 men diagnosed with prostate cancer from 1998 to 2009. Cancers were categorized as low, intermediate, or high risk, and imaging rates were evaluated over time and regionally.

A total of 36% of participants underwent imaging within 6 months of their prostate cancer diagnosis. Among men with low-risk prostate cancer, imaging rates decreased from 45% before the campaign to just 3% in 2009. Imaging rates for high-risk cancer patients decreased as well, from 63% to 47%. Although the results varied by region, each area experienced statistically significant drops in prostate cancer imaging.

Inappropriate use of imaging in low-risk prostate cancer patients is a problem recognized by organizations such as the American Society of Clinical Oncology. The authors suggest that a US campaign to promote imaging guidelines may also be effective in reducing prostate cancer imaging.