High-Cost Imaging of Advanced Cancer Patients Increasing
(HealthDay News) – Use of imaging in Stage IV cancer patients increased from 1995–2006, according to a study published online July 31 in the Journal of the National Cancer Institute.
To examine patterns in high-cost diagnostic imaging use among elderly patients with Stage IV cancer, Yue-Yung Hu, MD, from Brigham and Women's Hospital in Boston, and colleagues used claims data from the Surveillance, Epidemiology, and End Results-Medicare database to identify 100,594 patients diagnosed with Stage IV breast, colorectal, lung, or prostate cancer from 1995–2006. All patients underwent computed tomography, magnetic resonance imaging, positron emission tomography, and/or nuclear medicine scans from 1994–2009.
The researchers found that, from 2002–2006, 95.9% of Stage IV patients underwent a high-cost diagnostic imaging procedure, with a mean number of 9.79 scans per patient and 1.38 scans per-patient per-month of survival. Among Stage IV patients, 75.3% were scanned again after the diagnostic stage and 34.3% were scanned in the last month of life. The proportion of Stage IV cancer patients imaged increased from January 1995–December 2006 (relative increase, 4.6%), while the proportion of early-stage cancer patients imaged decreased (relative decrease, −2.5%).
"Imaging, although it often leads to (appropriate) palliative measures, may also distract patients from focusing on achievable end-of-life goals, require them to spend more of their limited time in medical care settings, and/or provoke anxiety," the authors write. "These procedures represent a costly, yet underappreciated and understudied aspect of care in this vulnerable population."