Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital
| Autor: | Justin F. Gainor, Wariya Chintanapakdee, Jo-Anne O. Shepard, Ariel Botwin, Matthew D. Gilman, Subba R. Digumarthy, Eric W. Zhang, Dexter P. Mendoza |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Malignancy Medicare 030218 nuclear medicine & medical imaging Lesion Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Lung cancer Early Detection of Cancer Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease Predictive value United States Axilla medicine.anatomical_structure 030220 oncology & carcinogenesis Ct technique Female Radiology medicine.symptom business Tomography X-Ray Computed Lung cancer screening |
| Zdroj: | Journal of the American College of Radiology : JACR. 17(12) |
| ISSN: | 1558-349X |
| Popis: | Purpose The aims of this study were to determine the prevalence and outcomes of extrapulmonary malignancies identified on lung cancer screening (LCS) and to determine the cost associated with the investigation of these lesions. Methods This retrospective study included 7,414 low-dose CT studies performed between June 2014 and December 2019 on 4,160 patients as part of an established LCS program. Patients with indeterminate extrapulmonary lesions were identified, and the diagnostic workup, management, and outcomes of the lesions were determined. Costs related to diagnostic evaluation were estimated using 2020 total facility relative value units and the 2020 Medicare conversion factor. Out-of-pocket costs were extracted from billing records. Results There were 20 extrapulmonary malignancies among 241 reported lesions in 225 patients (mean age, 66.1 ± 6.4 years; 109 men, 116 women). The prevalence of extrapulmonary malignancy was 20 of 4,160 (0.48%). Early-stage cancers were detected in 13 of 20 (65%). No cancer-specific mortality was observed. The predictive value for malignancy varied by organ (P = .03) and was highest in the chest wall and axilla (36.4%), followed by bone (25%). The average cost on the basis of Medicare reimbursement for diagnosis of an extrapulmonary malignancy on LCS was $1,316.03 ($6.33 per participant and $109.21 per indeterminate incidental lesion). Most patients (203 of 225 [90.2%]) did not have out-of-pocket costs related to diagnostic workup. In those who did, the median cost was $160.60 (range, $75-$606.76). Conclusions Low-dose CT for LCS detects extrapulmonary malignancy with high predictive value for certain locations. There is cost associated in the workup related to these incidental lesions, but most malignancies are detected at early stages and have good outcomes. |
| Databáze: | OpenAIRE |
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