Increase in use of imaging scans underscores need for evidence-based protocols in cancer care

May 14 2010

New research showing a more than 30 percent annual increase in the use of high-tech imaging scans in older cancer patients underscores the need for evidence-based protocols in cancer care, said MedSolutions (www.medsolutions.com), a leading provider of medical management services.

According to an article published in the April 28, 2010 issue of the Journal of the American Medical Association, the use of CT scans and PET scans in cancer patients covered by Medicare has risen significantly in recent years. Costs associated with these tests are growing faster than total cancer care costs in Medicare patients. Both CT and PET scans expose patients to high levels of potentially dangerous radiation.

"These findings illustrate the need for broader adoption of evidence-based protocols in cancer care," said Gregg Allen, M.D., chief medical officer of MedSolutions. "Advanced imaging is essential to proper cancer diagnosis, staging and treatment, and some ongoing imaging in cancer is entirely appropriate. However, due to rapidly evolving advances in and application of medical technology, many physicians need greater support in determining when the benefits of a test outweigh its cost and risk.  These benefits and risks should also be shared with and clearly understood by patients and caregivers."

MedSolutions' oncology management program uses evidence-based guidelines from nationally recognized oncology organizations to support appropriate use of diagnostic imaging, radiation therapy and drugs for cancer patients. The program is designed to reduce variability in cancer treatment by focusing on proven approaches shown to yield more predictable outcomes, thereby improving quality while significantly lowering the overall cost of care.

PET scans, which can cost more than $2,000 each, have grown most dramatically, increasing an average of 35.9 percent to 53.6 percent annually depending on the type of cancer. CT scans have also increased. Lung cancer patients diagnosed in 2006 had an average of six CT scans over a two-year period compared with four scans for patients diagnosed in 1999.

Average two-year costs of all types of cancer imaging tests, including standard X-rays and MRI scans, rose 5.1 to 10.3 percent per patient each year. This data suggests that costly advanced imaging scans are often performed in addition to more conventional studies.

"The rapid increase in all types of imaging reflects a 'more is better' mentality that does not always translate to better outcomes," said Dr. Allen. "In addition to subjecting patients to unnecessary and potentially harmful radiation, additional testing often leads to costly medical interventions that are not supported by evidence-based guidelines and can result in greater downstream medical costs."

The study is the latest in a growing body of data highlighting the potential for misuse and overutilization of cancer imaging. Members of Congress recently asked the Government Accountability Office (GAO) to initiate a study on the effects of physician self-referral for advanced medical imaging and radiation therapy treatments on Medicare spending. Research shows that self-referring physicians are up to 7.7 times more likely to order imaging than non-self referring physicians, resulting in 20 to 60 percent higher costs.

Cancer is the second most common cause of death in America. According to the American Cancer Society, nearly 1.5 million new cancer cases are expected this year, accounting for an estimated $93.2 billion in direct medical expenditures. Cancer-related expenditures are expected to grow faster than any other area of healthcare. Utilization of chemotherapy, radiation therapy and advanced imaging is expected to grow 33 percent, 45 percent and 59 percent respectively over the next 10 years while spending on cancer medications continues to increase by an estimated 14 percent annually.

SOURCE MedSolutions