Utilization of diagnostic studies in the pretreatment evaluation of invasive cervical cancer in the United States: Results of intergroup protocol ACRIN 6651/GOG 183 Journal Article
| Authors: | Amendola, M. A.; Hricak, H.; Mitchell, D. G.; Snyder, B.; Chi, D. S.; Long, H. J. 3rd; Fiorica, J. V.; Gatsonis, C. |
| Article Title: | Utilization of diagnostic studies in the pretreatment evaluation of invasive cervical cancer in the United States: Results of intergroup protocol ACRIN 6651/GOG 183 |
| Abstract: | Purpose: To review the current utilization of diagnostic tests prescribed by the International Federation of Gynecology and Obstetrics (FIGO) clinical staging guidelines in the pretreatment work-up of invasive cervical cancer, and to compare the data with those of previous patterns of care studies. Patients and Methods: This interdisciplinary American College of Radiology Imaging Network/Gynecologic Oncology Group prospective clinical trial was conducted between March 1, 2000, and November 11, 2002. Twenty-five participating institutions, all from the United States, enrolled a total of 208 patients. Only patients scheduled for surgery with biopsy-confirmed cervical cancer of clinical FIGO stage IB or higher were eligible. The patterns of care data analysis was based on 197 patients who met all inclusion criteria. The conventional FIGO-recommended tests used for pre-enrollment FIGO clinical stage classification were at the discretion of the treating physician; overall frequency of use was tabulated for each test. Results: Use of cystoscopy (8.1%) and sigmoidoscopy or proctoscopy (8.6%) was significantly lower than in 1988 to 1989 (P < .0001 in each instance). Intravenous urography was used in only 1% of patients as compared with 42% in 1988 to 1989 and 91% in 1983. No patient included in the data analysis had barium enema or lymphangiography. Only 26.9% of patients had examination under anesthesia for FIGO clinical staging. Conclusion: There is a large discrepancy between the diagnostic tests recommended by FIGO and the actual tests used for cervical cancer staging, suggesting a need to reassess the relevance of the FIGO guidelines to current clinical practice in the United States. © 2005 by American Society of Clinical Oncology. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; clinical trial; united states; cancer patient; comparative study; cancer staging; hysterectomy; neoplasm staging; prospective study; prospective studies; clinical practice; controlled clinical trial; clinical protocol; practice guideline; diagnostic imaging; cancer invasion; health care quality; standard; health care utilization; utilization review; cancer center; multicenter study; uterine cervix cancer; medical society; oncology service, hospital; neoplasm invasiveness; cystoscopy; diagnostic test; cancer classification; uterine cervical neoplasms; sigmoidoscopy; uterine cervix tumor; uterine cervix biopsy; lymphangiography; barium enema; process assessment (health care); diagnostic tests, routine; intravenous urography; rectoscopy |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 23 |
| Issue: | 30 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2005-10-20 |
| Start Page: | 7454 |
| End Page: | 7459 |
| Language: | English |
| DOI: | 10.1200/jco.2004.00.5397 |
| PUBMED: | 16234512 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 29" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work