uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Prostate Cancer Imaging Trends After a Nationwide Effort to Discourage Inappropriate Prostate Cancer Imaging
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Show others and affiliations
2013 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 105, no 17, 1306-1313 p.Article in journal (Refereed) Published
Abstract [en]

Background Reducing inappropriate use of imaging to stage incident prostate cancer is a challenging problem highlighted recently as a Physician Quality Reporting System quality measure and by the American Society of Clinical Oncology and the American Urological Association in the Choosing Wisely campaign. Since 2000, the National Prostate Cancer Register (NPCR) of Sweden has led an effort to decrease national rates of inappropriate prostate cancer imaging by disseminating utilization data along with the latest imaging guidelines to urologists in Sweden. We sought to determine the temporal and regional effects of this effort on prostate cancer imaging rates. Methods We performed a retrospective cohort study among men diagnosed with prostate cancer from the NPCR from 1998 to 2009 (n = 99 879). We analyzed imaging use over time stratified by clinical risk category (low, intermediate, high) and geographic region. Generalized linear models with a logit link were used to test for time trend. Results Thirty-six percent of men underwent imaging within 6 months of prostate cancer diagnosis. Overall, imaging use decreased over time, particularly in the low-risk category, among whom the imaging rate decreased from 45% to 3% (P < .001), but also in the high-risk category, among whom the rate decreased from 63% to 47% (P < .001). Despite substantial regional variation, all regions experienced clinically and statistically (P < .001) significant decreases in prostate cancer imaging. Conclusions A Swedish effort to provide data on prostate cancer imaging use and imaging guidelines to clinicians was associated with a reduction in inappropriate imaging over a 10-year period, as well as slightly decreased appropriate imaging in high-risk patients. These results may inform current efforts to promote guideline-concordant imaging in the United States and internationally.

Place, publisher, year, edition, pages
2013. Vol. 105, no 17, 1306-1313 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-208651DOI: 10.1093/jnci/djt175ISI: 000324038500011OAI: oai:DiVA.org:uu-208651DiVA: diva2:654011
Available from: 2013-10-07 Created: 2013-10-07 Last updated: 2013-10-07Bibliographically approved

Open Access in DiVA

fulltext(465 kB)359 downloads
File information
File name FULLTEXT01.pdfFile size 465 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text
By organisation
UCR-Uppsala Clinical Research Center
In the same journal
Journal of the National Cancer Institute
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 359 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 229 hits
ReferencesLink to record
Permanent link

Direct link