Evaluation of the duplication of staging CT scans for localized colon cancer in a Medicare population.
Med Care
; 52(11): 963-8, 2014 Nov.
Article
en En
| MEDLINE
| ID: mdl-25226545
ABSTRACT
BACKGROUND:
To quantify and characterize duplicated tests performed during the staging of localized colon cancer in the Medicare population.METHODS:
We used the SEER-Medicare linked database to select patients diagnosed with localized colon cancer between the years 1996 and 2009. We considered a patient as adequately staged after having received a colonoscopy, an abdominal computed tomography (CT) scan, and a pelvic CT scan. Abdominal and pelvic CT scans performed between complete staging and first cancer-directed treatment, if not ordered due to an acute condition, were considered duplicates. We characterized the institutions providing the tests and evaluated the association with survival using a weighted pooled logistic regression adjusted by baseline and time-varying confounders.RESULTS:
Of 36,291 patients with a complete staging, 2680 (7.4%) had at least 1 duplicated test. Patients receiving a duplicate had a higher comorbidity score, were more symptomatic, and had more visits to the emergency department and clinical evaluations. They also were treated with surgery less frequently and had worse survival (hazard ratio 1.22, 95% confidence interval, 1.16-1.28). The type of institution involved in the staging (nonprofit/government centers, proprietary centers, free-standing facilities) was not associated with receiving duplicated tests.CONCLUSIONS:
We found a low frequency of duplicated abdominal or pelvic CT scans in the staging of colon cancer in the Medicare population.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_colon_rectum_cancers
Asunto principal:
Tomografía Computarizada por Rayos X
/
Medicare
/
Neoplasias del Colon
/
Procedimientos Innecesarios
/
Estadificación de Neoplasias
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2014
Tipo del documento:
Article
País de afiliación:
Marruecos