434 CONTEMPORARY TRENDS IN IMAGING USE IN MEN DIAGNOSED WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness1 Apr 2011434 CONTEMPORARY TRENDS IN IMAGING USE IN MEN DIAGNOSED WITH PROSTATE CANCER Sima Porten, Alexandria Smith, Anobel Odisho, Mark Litwin, Christopher Saigal, Peter Carroll, and Matthew Cooperberg Sima PortenSima Porten San Francisco, CA More articles by this author , Alexandria SmithAlexandria Smith Los Angeles, CA More articles by this author , Anobel OdishoAnobel Odisho San Francisco, CA More articles by this author , Mark LitwinMark Litwin Los Angeles, CA More articles by this author , Christopher SaigalChristopher Saigal Los Angeles, CA More articles by this author , Peter CarrollPeter Carroll San Francisco, CA More articles by this author , and Matthew CooperbergMatthew Cooperberg San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.525AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies from a large community cohort of men with prostate cancer reported a decrease in use of imaging tests for localized disease. However, other reports have found ongoing overuse of imaging for low risk disease. We aimed to determine updated trends of imaging utilization in three large cohorts of men with various stages of prostate cancer. METHODS We analyzed imaging trends in three large datasets of men with prostate cancer who were a part of Cancer of the Prostate Strategic Urologic Research Endeavor CaPSURE (1991–2007), were insured by Medicare (1998–2006), or were privately insured men (i3 database, 2002–2006). The rates of computerized tomography (CT), magnetic resonance imaging (MRI), and bone scan (BS) were determined in each cohort and time trends were analyzed by linear regression. For men in CaPSURE, demographic and clinical predictors of test use were explored using a multivariable regression model. RESULTS Since 1991, there was a significant downward trend in BS and MRI use in the CaPSURE cohort. (Figure) However, CT use increased, particularly from 1999–2007. Among 54,322 Medicare patients, BS, CT, and MRI use increased by 2.1%, 10.8%, and 2.2% and in 16,161 privately insured patients, use increased by 7.9%, 8.9%, and 3.7% from during each study period respectively (Figure 1). In CaPSURE, The use of any imaging test was greater in men with higher risk disease. Men with Veteran's Affairs coverage were more likely to have a BS (OR 1.29, 1.23–1.35) and less likely to have a CT (OR 0.58, 0.36–0.96). Men with higher income had greater odds of MRI (OR 3.06, 1.19–7.91). CONCLUSIONS The use of imaging tests in men with prostate cancer appears to be increasing, despite the downward risk migration of the disease. This trend is greatest in the use of computerized tomography. Although imaging use appears to be associated with overall disease risk, other sociodemographic factors were predictive of use. These findings highlight the need for examination of incentives and other factors that drive over-use of imaging. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e175 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sima Porten San Francisco, CA More articles by this author Alexandria Smith Los Angeles, CA More articles by this author Anobel Odisho San Francisco, CA More articles by this author Mark Litwin Los Angeles, CA More articles by this author Christopher Saigal Los Angeles, CA More articles by this author Peter Carroll San Francisco, CA More articles by this author Matthew Cooperberg San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...