MedicalResearch.com Interview with:
Mark A. Healy, MD
Department of Surgery
Center for Healthcare Outcomes & Policy, University of Michigan
Ann Arbor, MI
Medical Research: What is the background for this study? What are the main findings?
Dr. Healy: In our study, we found high overall use of PET as a primary study for recurrence detection in lung and esophageal cancers, with substantial hospital-based variation in the use of PET. Despite this, there was not a significant difference in survival for patients across high and low PET use hospitals.
Medical Research: What should clinicians and patients take away from your report?
Dr. Healy: PET is a great technology, and it is very useful in cancer staging, re-staging and follow-up for treatment response. However, physicians should avoid ordering these studies in asymptomatic patients who have already been treated for their cancer, unless it is to follow up a suspicious finding on a lower cost scan such as CT. For patients, if you have been treated for your cancer and are doing well with no symptoms, there is no reason to seek these scans out.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Healy: On the policy side, CMS currently limits reimbursement for PET scans to three per patient for those who have completed their anti-cancer therapy. It appears that there are not many patients who would reach this limit, but still with thousands of patients undergoing one or two of these scans, the cost is likely quite high. This should be studied further as more data accumulates from after CMS’s 2013 policy.
More work should also be done to see if these extra scans led to more downstream procedures or other treatments, and if these happened, how they affected patient outcomes.
Mark A. Healy, Huiying Yin, Rishindra M. Reddy, and Sandra L. Wong
Use of Positron Emission Tomography to Detect Recurrence and Associations With Survival in Patients With Lung and Esophageal CancersJNCI J Natl Cancer Inst (2016) 108 (7): djv429 doi:10.1093/jnci/djv429 First published online February 22, 2016 (8 pages)
Mark A. Healy, MD (2016). PET Scans May Be Overused To Detect Recurrent Lung Cancer