Utilization of pre-operative imaging for colon cancer: A population-based study

J Surg Oncol. 2017 Feb;115(2):202-207. doi: 10.1002/jso.24492. Epub 2016 Nov 4.


Objective: To assess the use of pre-operative imaging for colon cancer and to identify factors associated with utilization in routine clinical practice.

Methods: This population-based, retrospective cohort study used a random sample of 25% of colon cancer patients treated with surgery in the province of Ontario (2002-2008). Pre-operative imaging (<16 weeks from surgery) of the chest, abdomen-pelvis was identified. Modified poisson regression was used to analyze factors associated with practice patterns.

Results: Of the 7,249 included patients, 48% had pre-operative imaging (CT abdomen and imaging of the chest) in keeping with guideline recommendations. The rate of guideline concordant pre-operative imaging increased over time: 64% in the most recent study period (2006-2008) versus 31% (2002-2004); P < 0.001. Variables associated with use of chest imaging: Age, co-morbidity, surgeon volume, and geographic region; no association with gender, hospital volume, or socio-economic status. Variables associated with use of abdomen imaging: Hospital volume and geographic region; no association with age, gender, comorbidity, socio-economic status, or surgeon volume.

Conclusion: In clinical practice, the majority of patients were not receiving pre-operative imaging that was in line with clinical practice guidelines; however, use increased over time indicating a possible association with dissemination of clinical practice guidelines. J. Surg. Oncol. 2017;115:202-207. © 2016 Wiley Periodicals, Inc.

Keywords: colon cancer; computed tomography; imaging; population-based study.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Canada / epidemiology
  • Colonic Neoplasms / diagnostic imaging*
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Preoperative Care
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Young Adult