Disparities in Diagnostic Imaging for Initial Local Staging for Rectal Cancer

Area of Science:

• Oncology
• Radiology
• Health Services Research

Background:

• Rectal cancer staging requires accurate imaging for treatment planning.
• Variability in imaging quality and access can impact patient outcomes.
• Sociodemographic factors may influence the utilization and quality of diagnostic procedures.

Purpose of the Study:

• To assess the presence, quality, and timeliness of initial staging imaging for rectal cancer patients.
• To identify demographic factors associated with disparities in imaging access and quality.

Main Methods:

• Chart review of 346 rectal adenocarcinoma cases (2015-2020).
• Evaluation of initial staging MRI/EUS presence, quality (Society of Abdominal Radiology protocol), and timeliness.
• Analysis of demographic factors (age, race, ethnicity, sex, insurance, income) and their association with imaging outcomes.

Main Results:

• 26.8% of patients lacked initial staging MRI or EUS.
• 72.4% of evaluated MRIs met quality criteria.
• Lower likelihood of staging associated with Hispanic ethnicity, Medicaid/no insurance, and low-income residence.
• Higher imaging quality linked to higher income, recent diagnosis, and in-house MRI.

Conclusions:

• Sociodemographic factors significantly impact initial local imaging for rectal cancer.
• There is a need to improve image acquisition for underserved populations.
• Standardization of imaging quality is crucial, especially at low-volume centers.