Canadian Association of Radiologists Cancer Diagnostic Imaging Referral Guideline

Area of Science:

• Oncology
• Radiology
• Clinical Guideline Development

Background:

• Physician panel identified 29 clinical/diagnostic scenarios for cancer diagnosis.
• 16 scenarios were referred to existing Canadian Association of Radiologists (CAR) guidelines.
• 13 scenarios required new referral recommendations.

Purpose of the Study:

• To develop evidence-based referral guidelines for specific cancer diagnostic scenarios.
• To provide clear recommendations for suspected cancers not covered by existing CAR guidelines.
• To focus solely on cancer diagnosis, excluding staging, follow-up, and surveillance.

Main Methods:

• Rapid scoping review of existing referral guidelines.
• Utilized recommendations from 21 systematic reviews.
• Applied Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework criteria.
• Formulated new recommendations for 12 distinct cancer diagnostic scenarios.

Main Results:

• Developed new referral recommendations for 12 cancer diagnostic scenarios.
• Mapped one additional scenario to an existing CAR guideline.
• Guideline covers suspected pancreatic, liver, anal, penile, cervical, endometrial/uterine, vulvar, vaginal, hematologic malignancies, and skin cancers, plus incidental liver and colon masses.
• Referred to existing CAR guidelines for 17 other cancer types and masses.

Conclusions:

• The guideline provides essential diagnostic referral pathways for specific suspected cancers.
• It complements existing CAR guidelines by addressing previously uncovered scenarios.
• The focus remains strictly on initial cancer diagnosis.