When PET scans were first introduced, Medicare did not pay for them, but by 2005 about 50 percent of patients with lung cancer and lymphoma were getting one or more PET scans, Schulman noted.
In 1999, patients diagnosed with lung cancer had about 21 imaging scans during the first two years of treatment. By 2006, that had increased to 24.
The highest imaging costs were for patients with lung cancer and lymphoma, averaging $3,000 during the first two years of treatment, the researchers found.
In addition, bone density studies increased in popularity. In fact, the number of breast cancer patients getting bone density studies almost doubled by 2005, with about one-third of all patients receiving one or more scans.
Michael T. French, a professor of economics, epidemiology and public health at the University of Miami, isn't surprised that these costs have gone up so dramatically.
"Imaging has advanced considerably in recent years," he said. "So, it's logical that it would be used more often, and along with the higher costs of increased use are the costs of improved technology."
French thinks that some of the increased use of imaging is related to increased reimbursement and competitiveness among hospitals. "Is there excessive use of imaging to improve profits? Yes," French said.
In addition, there is a defensive aspect to the increased use of imaging, French said. "If the technology is present and physicians don't use it, then if something happens to the patient there is a possibility for a lawsuit," he said.
The bottom-line question is how imaging is being used, French said. "It's a question of whether it's wasteful or whether it's higher cost to produce better outcomes," French said. "Right now, we don't know what all this leads to in terms of better outcomes."
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