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Pretreatment staging of colon cancer in the Swedish population.

https://arctichealth.org/en/permalink/ahliterature258049
Source
Colorectal Dis. 2013 Nov;15(11):1361-6
Publication Type
Article
Date
Nov-2013
Author
A. Sjövall
L. Blomqvist
A. Martling
Author Affiliation
Center of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
Source
Colorectal Dis. 2013 Nov;15(11):1361-6
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - radiography - secondary - surgery
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Colonic Neoplasms - pathology - radiography - surgery
Emergencies
Female
Guideline Adherence - statistics & numerical data
Humans
Liver Neoplasms - diagnosis - secondary
Lung Neoplasms - diagnosis - secondary
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging - standards - statistics & numerical data
Practice Guidelines as Topic
Preoperative Period
Surgical Procedures, Elective - statistics & numerical data
Sweden
Tomography, X-Ray Computed
Young Adult
Abstract
Preoperative staging of colon cancer according to Swedish national guidelines implies imaging evaluation of the primary tumour, liver and lungs. Failure to adhere to these guidelines results in negative scorings in the national registration system. In the present study we report the extent of compliance with these guidelines.
Since 2007 clinical data on all patients diagnosed with colon cancer in Sweden have been collected in a national database. This includes information on pretherapeutic diagnostic imaging performed, pretherapeutic TNM stage and data on treatment and follow-up. All patients diagnosed with colon cancer in Sweden between 2007 and 2010 were included.
Nine thousand and eight-three patients (i.e. 60.5% of all patients) had a complete pretherapeutic radiological evaluation; 65.2% had a CT or MRI of the primary tumour, whereas over 80% had examinations of the liver and lungs. There were no difference related to sex, but more patients under 75 years had a complete evaluation. There were large differences between different regions; one region performed a complete evaluation of 78.3% of all patients. The proportion of patients examined increased from 53.9 to 65.0% during the study period. Elective cases were more frequently evaluated before treatment than those with an emergency presentation.
Most patients in Sweden had a complete pretreatment imaging evaluation of the colon cancer with geographical and time-dependent variations. Knowledge of the importance of these variations and correlation of pre- and postoperative TNM stage is warranted, and such studies are ongoing.
PubMed ID
23773574 View in PubMed
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Staging practice for prostate cancer varies and is not in line with clinical guidelines.

https://arctichealth.org/en/permalink/ahliterature280940
Source
Dan Med J. 2016 Dec;63(12)
Publication Type
Article
Date
Dec-2016
Author
Lars J Petersen
Yuliya Shuytsky
Helle D Zacho
Source
Dan Med J. 2016 Dec;63(12)
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Bone Neoplasms - diagnostic imaging - secondary
Denmark
Guideline Adherence - trends
Humans
Magnetic Resonance Imaging
Male
Neoplasm Grading
Neoplasm Staging - standards
Practice Guidelines as Topic
Prospective Studies
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood - pathology
Surveys and Questionnaires
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
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.
PubMed ID
27910797 View in PubMed
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