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Increase in Cancer Imaging Illustrates Need for Evidence-Based Care
Date:5/13/2010

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,(1) 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.(2)


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