Introduction/Background Joint SOCG-GOC-SCG clinical practice guidelines recommend against preoperative imaging studies (such as CT), except for cases of locally advanced disease or aggressive histologies. This study utilized population-based data to evaluate the use of preoperative imaging in Ontario and factors associated with its use.
Methodology Ontario women diagnosed with endometrial cancer from 2006–2016 were identified from the Ontario Cancer Registry. Patients with a hysterectomy prior to the date of diagnosis, non- epithelial histology or a prior cancer diagnosis within 5 years were excluded. Age-standardized incidence rate of endometrial cancer and preoperative imaging (CT or MRI) rates were calculated over time. Predictive factors for preoperative imaging use were determined using multi-variable analysis. A subanalysis was performed on low-risk patients, to determine if preoperative imaging use differed in this population.
Results 21641 cases were included for analysis. From 2006–2016, the number of cases of endometrial cancer increased 48.0%, and age-standardized incidence rate increased 17.6%.
The use of preoperative imaging increased from 19.3% to 32.6%. In a subanalysis of a low-risk population, the rate of preoperative imaging was 16%, compared with 26.8% in the combined population. Factors most predictive of preoperative imaging were: non-endometrioid histology, higher stage, higher grade, comorbidity score and rurality score.
Conclusion Endometrial cancer incidence and the use of preoperative imaging has increased from 2006–2016 in Ontario. Guideline compliance was moderate; while preoperative imaging use was associated with high risk features, inappropriate use was still seen in the low risk population.
Disclosure Nothing to disclose.
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