Study: PET Scans Overused in Lung Cancer Patients

New study findings suggest that the frequency of PET scans for follow-up in lung and esophageal cancer patients ranges greatly between hospitals, and the imaging tool isn’t having a significant impact on survival rates.

A team led by investigators from the University of Michigan Medical School sought to analyze widespread use of PET scans—a costly but potentially effective tool that isn’t typically recommended as a first option to monitor cancer patients for recurrence over the long term. The researchers evaluated Medicare data for more than 100,000 lung and esophageal cancer patients who had cancer in the mid-2000s and received follow-up care through 2011.
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Overall, more than 22% of the lung cancer patients and 31% of esophageal cancer patients had undergone at least 1 PET scan to monitor for cancer recurrence over the course of their follow-up period, without having a CT scan or other imaging procedure done first. The authors found that hospitals varied significantly in terms of how often they followed this course, with some very rarely adopting this approach and others doing it in a majority of cases. Some hospitals used this approach 8 times as often as others, according to the researchers.

The team found that patients who went to hospitals with high usage rates of PET scans for lung cancer follow-up were just as likely to survive for 2 years as those who went to hospitals with low PET use.

“If a patient has been treated for their cancer and is not having any symptoms, there is no need to obtain a PET scan for routine follow-up,” says Mark Healy, MD, a surgical resident and research fellow in the University of Michigan department of surgery, a member of the school’s Center for Health Outcomes & Policy, and lead author of the study.

“For patients [who] have completed treatment and are not having symptoms, then there is no reason to seek this scan out.”

The ordering of surveillance scans “should be done with the guidance of oncology or surgical oncology professionals,” adds Rishindra Reddy, MD, FACS, study co-author and a surgeon at the University of Michigan.

“A great reference for patients and primary care physicians,” continues Reddy, “is the National Comprehensive Cancer Network,” which offers guidelines on how and when to order surveillance scans at nccn.org/professionals/physicians_gls/f_guidelines.asp.

—Mark McGraw

Reference

Healy M, Yin H, et al. Use of Positron Emission Tomography to Detect Recurrence and Associations With Survival in Patients With Lung and Esophageal Cancers. JNCI J Natl Cancer Inst. 2016.