Heavily used diagnostic imaging increases costs for patients with cancer

Changing treatment options for cancer patients has led to an increase in both the use and cost of diagnostic imaging, according to a study published in JAMA (2010;303(16):1625-1631).

To examine the changes in the use and costs of imaging and how these changes have influenced cancer-related expenditures, Michaela Dinan, BS, of the Duke Clinical Research Institute, and colleagues analyzed a nationally representative 5% sample of Medicare and Medicaid claims. Among the analyzed sample, researchers identified 100,954 new cases of breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma, and prostate cancer.

Results of the study revealed that in each subset of cancer type, the number of positron emission tomography (PET) scans per beneficiary increased at an average annual rate of 35.9% to 53.6%. “Patients with lung cancer or lymphoma had the largest increase in PET use, accompanied by an overall reduction of conventional nuclear medicine imaging tests in both cancer types and stabilized computed tomography [CT] in the lymphoma group. Increases also occurred in the use of bone density scans, echocardiograms, magnetic resonance imaging, and ultrasound. Use of CT increased in all cancer subgroups except lymphoma,” the authors wrote.

Furthermore, researchers also reported that for all cancer types, average 2-year imaging costs per beneficiary increased between 5.1% and 10.3% per year, at least double the rate of increase in overall costs.

“It is unclear whether the rapid increase in use of advanced imaging is a result of the novelty of the technologies, better outcomes, or a shift to new revenue sources after the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act,” the authors concluded.

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