By looking at medical records from across 84 hospital referral regions (HRRs), researchers found that men with low-risk prostate cancer and women with low-risk breast cancer received unnecessary imaging in over 40 percent of the cases sampled. The percentage of overuse on a region by region basis varied considerably.

"Our study suggests that regions may have inherent characteristics, over and above market structure and competition, underlying health care decisions across diseases. Future work should further characterize determinates of these regional tendencies," wrote Dr. Danil V. Makarov, department of urology at New York University School of Medicine, and colleagues, in the report.

The study looked at 9,219 men and 30,298 women treated between 2004 and 2007, and found for men with low-risk prostate cancer, imaging was overused in 44.4 percent of the cases. For women, overuse happened in 42 percent of the cases.
For men with low-risk prostate cancer, frequency of inappropriate imaging was not associated with race, year of diagnosis, median household income, or marital status.

However, rates of inappropriate imaging for women with low-risk breast cancer were associated with race (black women imaged most), year of diagnosis (more frequently with each passing year), median income (most frequent imaging for median income $50,000-$63,000 annually), and marital status (married women imaged most).

The researchers based their findings on the use of CT and bone scans for prostate cancer, and CT, MR, and PET scans for breast cancer. It is also worth noting that the studies they examined took place in the years prior to the Choose-Wisely Initiative, which set forth recommendations to limit the overuse of medical imaging.

The authors, who say more research should be done to determine how effective the Choose-Wisely Initiative has been in correcting the overuse, published their findings online on March 12th in JAMA Oncology.

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