Staging Studies for XXXX in the United States: A Population-Based Analysis.

@entity1 @entity5 @entity320
BACKGROUND: Routine cross-sectional imaging for staging of early-stage cutaneous @entity320 is not recommended. This study sought to investigate the use of imaging for staging of cutaneous @entity320 in the United States. METHODS: @entity1 with nonmetastatic cutaneous @entity320 newly diagnosed between 2000 and 2007 were identified from the Surveillance Epidemiology End Results-Medicare registry. Any imaging study performed within 90  days after diagnosis was considered a staging study. RESULTS: The study identified 25,643 @entity1 , 3,116 (12.2  %) of whom underwent cross-sectional imaging: positron emission tomography (PET) (7.2  %), computed tomography (CT) (5.9  %), and magnetic resonance imaging (MRI) (0.6  %). From 2000 to 2007, the use of cross-sectional imaging increased from 8.7 to 16.1  % (p  <  0.001), driven predominantly by increased usage of PET (4.2-12.1  %). Stratification by T and N classification showed that cross-sectional imaging was used for 8.6  % of T1, 14.3  % of T2, 18.6  % of T3, and 26.7  % of T4 @entity5 (p  <  0.001) and for 33.3  % of node-positive @entity1 versus 11.1  % of node-negative @entity1 (p  <  0.001). Factors predictive of cross-sectional imaging included T classification [odds ratio (OR) for T4 vs T1, 2.66; 95  % confidence interval (CI) 2.33-3.03], node positivity (OR 2.70; 95  % CI 2.36-3.10), more recent year of diagnosis (OR 2.05 for 2007 vs 2000; 95  % CI 1.74-2.42), atypical histology, and non-Caucasian race (OR 1.32; 95  % CI 1.02-1.73). CONCLUSIONS: The use of cross-sectional imaging for staging of early-stage cutaneous @entity320 is increasing in the Medicare population. Better dissemination of guidelines and judicious use of imaging should be encouraged.
