Monday, August 30, 2010

Good News, Cancer Rates and Health Care Costs Decreasing

"Part of the explosion in medical imaging over the past two decades may be attributable to overuse, and steps need to be taken to cut back," according to a study in the journal Radiology, MedPage Today/ABC News reports.
"Initiatives include rewriting the fee-for-service system, curbing physician self-referral practices, and creating appropriateness criteria for imaging, according to William R. Hendee of the Medical College of Wisconsin in Milwaukee and colleagues. … Imaging services and their costs have grown at about twice the rate of other technologies in healthcare including lab procedures and pharmaceuticals, Hendee and colleagues wrote." Overuse of imaging "also exposes the public to unnecessary radiation." The authors "called for a national effort to develop evidence-based appropriateness criteria for imaging, so that physicians can make greater use of practice guidelines in requesting and conducting imaging studies" (Fiore, 8/29).
This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Several recent studies show the risk of cancer associated with CT scans appears to be greater than previously believed.
study published last year in the Archives of Internal Medicine projected that 29,000 future cancers will be directly attributable to the 57 million CT scans performed in the United States in 2007.
Another study last year by the National Council on Radiation Protection and Measurements found medical imaging was responsible for about half the total radiation exposure to the typical U.S. resident, up from just 20 percent in the 1980s. The council was chartered by Congress to recommend ways to limit radiation exposure.
A 2007 study published in The New England Journal of Medicine estimated that 0.4 percent of all cancers in the country may be attributable to the radiation from CT studies. By adjusting this estimate for current CT use, this estimate might now be as high as 2 percent.
"By definition, an unnecessary exam that uses radiation, such as a CT scan, is an unnecessary exposure to radiation and, in self-referring facilities, perhaps an inordinately high radiation dose since many of them are not properly accredited," said John Patti, chairman of the American College of Radiology’s board of chancellors.


To have something in the journal Radiology that calls for evidence-based guidelines for when to order a CT.......  Leaves me speechless.

This combined with the decreases in screening mammograms will decrease cancer rates noticeably and cut a major source of revenue for hospitals and specialists.   Health care expenditures are going to decrease because of this.   That's not good news for the larger institutions' bottom line.  

So let's summarize:

Less cancer + less expensive health care =  financial hardship for radiologists,  oncologists and hospitals

That's a recipe for disaster,  having the incentives between patients and institutions clash so completely.

Let's see if I find a copy of the journal articles themselves.

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