Use and costs of imaging rising faster than cost of cancer care

DURHAM, N.C. –  (Cancer Digest) – The cost of imaging cancer is rising at double the rate of increase for overall costs of cancer care, a new study of Medicare patients shows.

Led by Michaela Dinan, of the Duke Clinical Research Institute, researchers analyzed usage and costs for all types of imaging associated with cancer care over a five-year period.
The technologies included x-rays, magnetic resonance imaging (MRIs), computed tomography (CT) scans, ultrasound, and positron emission tomography (PET). While use and costs increased for all the imaging technologies, PET topped the list with the number of PET images taken, rising at an annual rate of 35.9 percent to 53.6 percent for lung cancer and lymphoma.



"Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer," the authors wrote. "The types and costs of imaging, including costly new imaging modalities, among Medicare beneficiaries with cancer have not been examined previously."

In the study appearing in the April 28 issue of the Journal of the American Medical Association Dinan and colleagues examined the use and costs of imaging for a nationally representative 5 percent sample of claims from the U.S. Centers for Medicare & Medicaid Services. During that period there were 100,954 new cases of breast, colorectal, prostate and lung cancers, leukemia and non-Hodgkin lymphoma.

Significant increases in use occurred with:

• Bone density scans (6.3 percent to 20.0 percent)
• Echocardiograms (5.0 percent to 7.8 percent)
• Magnetic resonance imaging (4.4 percent to 11.5 percent)
• Ultrasound (0.7 percent to 7.4 percent).

Use of CT scans increased in all cancer subgroups except lymphoma by 4.5 percent to 7.6 percent. Use of conventional x-rays decreased or stayed the same in each cancer subgroup but remained the most heavily used imaging modality for all diagnoses, at an average of 4.3 to 12.2 procedures per patient.

Dinan’s group also found that imaging costs for Medicare patients rose at a rate outpacing the rate of increase for total costs among Medicare beneficiaries with cancer.

For all cancer types, average two-year imaging costs per beneficiary increased between 5.1 percent and 10.3 percent per year, at least double the rate of increase in overall cancer care costs, which rose 1.8 percent to 4.6 percent per year. Imaging costs for all cancers studied also accounted for a larger percentage of total costs in those diagnosed in 2006 than in all previous years.

The researchers noted that cancer-related expenditures are expected to increase faster than any other area of health care as the population ages.

SOURCE: adapted from press materials provided by Duke Clinical Research Institute and the Journal of the American Medical Association re.; JAMA. 2010;303[16]:1625-1631