CT screening for comorbid disease in patients with prostatic carcinoma

Is it cost-effective?

H. P. Forman, Jay Heiken, J. A. Brink, H. S. Glazer, L. A. Fox, B. L. McClennan, J. R. Thornbury

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVE. The role of imaging in patients with newly diagnosed prostatic carcinoma is controversial. Currently, 35% of patients with prostatic carcinoma undergo CT at the time of diagnosis, despite reports of the lack of efficacy of CT in staging the disease. We sought to evaluate the cost- effectiveness of CT in detecting unrelated comorbid disease (significant disease unrelated to prostatic carcinoma) that might affect decisions on treatment in this population of patients. MATERIALS AND METHODS. We reviewed the medical records of 273 consecutive patients with newly diagnosed prostatic carcinoma who had CT of the abdomen and pelvis as part of their preoperative evaluation. Using costs based on Medicare reimbursements, we assessed the impact of the CT findings (related to comorbid disease) on overall costs and savings related to the workup and treatment of these patients. RESULTS. Sixty-six patients (24%) had findings suggestive of comorbid disease. The CT findings had near-term impact on only four patients (two in whom large abdominal aortic aneurysms were detected and two in whom second primary cancers were found), despite nearly $155,000 spent on the screening CT scans and more than $4400 spent on further evaluation of false- positive CT findings. The clinical impact varied from intervening semiurgent surgery to cancellation of prostatic surgery and institution of radiation therapy. CONCLUSION. CT is not cost-effective in screening for comorbid disease that would affect treatment in patients with newly diagnosed prostatic carcinoma.

Original languageEnglish (US)
Pages (from-to)1125-1130
Number of pages6
JournalAmerican Journal of Roentgenology
Volume162
Issue number5
StatePublished - Jan 1 1994
Externally publishedYes

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Carcinoma
Costs and Cost Analysis
Second Primary Neoplasms
Cost Savings
Abdominal Aortic Aneurysm
Medicare
Pelvis
Abdomen
Cost-Benefit Analysis
Medical Records
Radiotherapy
Therapeutics
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Forman, H. P., Heiken, J., Brink, J. A., Glazer, H. S., Fox, L. A., McClennan, B. L., & Thornbury, J. R. (1994). CT screening for comorbid disease in patients with prostatic carcinoma: Is it cost-effective? American Journal of Roentgenology, 162(5), 1125-1130.

CT screening for comorbid disease in patients with prostatic carcinoma : Is it cost-effective? / Forman, H. P.; Heiken, Jay; Brink, J. A.; Glazer, H. S.; Fox, L. A.; McClennan, B. L.; Thornbury, J. R.

In: American Journal of Roentgenology, Vol. 162, No. 5, 01.01.1994, p. 1125-1130.

Research output: Contribution to journalArticle

Forman, HP, Heiken, J, Brink, JA, Glazer, HS, Fox, LA, McClennan, BL & Thornbury, JR 1994, 'CT screening for comorbid disease in patients with prostatic carcinoma: Is it cost-effective?', American Journal of Roentgenology, vol. 162, no. 5, pp. 1125-1130.
Forman HP, Heiken J, Brink JA, Glazer HS, Fox LA, McClennan BL et al. CT screening for comorbid disease in patients with prostatic carcinoma: Is it cost-effective? American Journal of Roentgenology. 1994 Jan 1;162(5):1125-1130.
Forman, H. P. ; Heiken, Jay ; Brink, J. A. ; Glazer, H. S. ; Fox, L. A. ; McClennan, B. L. ; Thornbury, J. R. / CT screening for comorbid disease in patients with prostatic carcinoma : Is it cost-effective?. In: American Journal of Roentgenology. 1994 ; Vol. 162, No. 5. pp. 1125-1130.
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