Overuse of imaging for staging XXXX .

@entity1 @entity72626 @entity15591 @entity263
PURPOSE: Routine imaging for staging @entity263 is not recommended according to current guidelines. We characterized patterns of care and factors associated with imaging overuse. MATERIALS AND METHODS: We used SEER-Medicare linked data to identify @entity1 diagnosed with @entity263 from 2004 to 2005, and determined if imaging (computerized tomography, magnetic resonance imaging, bone scan, abdominal ultrasound) was obtained following @entity263 diagnosis before treatment. RESULTS: Of the 6,444 @entity1 identified with low risk disease 2,330 (36.2%) underwent imaging studies. Of these @entity1 1,512 (23.5%), 1,710 (26.5%) and 118 (1.8%) underwent cross-sectional imaging (computerized tomography or magnetic resonance imaging), bone scan and abdominal ultrasound, respectively. Radiation therapy vs surgery was associated with greater odds of imaging ( @entity15591 , 95% CI 1.68-2.35, p <0.01), while active surveillance vs surgery was associated with lower odds of imaging (OR 0.44, 95% CI 0.34-0.56, p <0.01). Associated with increased odds of imaging was median household income greater than  60,000 (OR 1.41, 95% CI 1.11-1.79, p <0.01), and @entity1 from New Jersey vs San Francisco ( @entity72626 , 95% CI 2.24-4.33, p <0.01) experienced greater odds of imaging. @entity1 living in areas with greater than 90% vs less than 75% high school education experienced lower odds of imaging (OR 0.76, 95% CI 0.6-0.95, p = 0.02). CONCLUSIONS: There is widespread overuse and significant geographic variation in the use of imaging to stage @entity263 . Moreover treatment associated variation in imaging was noted with the greatest vs lowest imaging use observed for radiation therapy vs active surveillance.
