Interventional radiology underrepresented in cancer guideline development
Interventional radiology is underrepresented in the development of U.S. cancer treatment guidelines, presenting opportunity for greater engagement, according to new research.
This assertion is based on an analysis of all active National Comprehensive Cancer Network guideline committees, as of early 2025. Out of thousands of panel slots, fewer than 2% were held by an IR specialist, researchers write Oct. 24 in the Journal of Vascular and Interventional Radiology.
Amid expanding use of image-guided therapies in oncology, IR specialists are calling for action to address this issue.
“These findings reveal that IR's presence in NCCN guideline development is both numerically limited and structurally narrow,” lead author Domenick Bartoletti, a student with Wright State’s Boonshoft School of Medicine, Dayton, Ohio, and colleagues wrote Saturday. “Even when restricted to clinically relevant panels, IR representation is largely sustained by a small cohort of repeat participants rather than broad specialty engagement,” they added.
For the study, researchers identified 20 guideline committees that are clinically relevant to interventional radiology because they address malignancies for which image-guided therapies can play a role. Across all 66 National Comprehensive Cancer Network committees, there were a total of 2,358 panel slots, held by 1,449 unique physicians.
Among this group, 36 panel slots (or 1.53%) carried a broad IR designation, including physicians listed as interventional radiologist alone or with a combined diagnostic designation. At the unique physician level, 11 docs were identified as IR specialists, representing 0.76% of unique physicians. When looking only at the subset of 20 IR-related guideline committees, 4.5% (or 34 of 756 slots) were occupied by someone in interventional radiology. Eighteen of 20 committees included at least one IR panelist, with bladder and small-cell lung cancer the only exceptions.
Participation was heavily concentrated among a small number of radiologists. About 82% of the panel slots were held by docs serving on two or more relevant panels. Plus, three physicians alone accounted for 12 of the 36 positions.
“Taken together, these data suggest that IR's formal influence on guideline development remains limited,” the authors concluded. “Although NCCN committee membership is based on recognized disease-specific expertise rather than specialty representation alone, the increasing integration of image-guided therapies into multidisciplinary oncologic care suggests there may be opportunities for broader participation by interventional radiologists on relevant disease-site panels. Such participation could help ensure that contemporary image-guided treatment options are appropriately represented during multidisciplinary guideline development.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.