Sanja Percac-Lima1, Jeffrey M Ashburner2, Jo-Anne O Shepard3, Inga T Lennes4, Dorothy E Rimmelin5, Steven J Atlas6. 1. Massachusetts General Hospital Chelsea HealthCare Center, Chelsea, Massachusetts; Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: Spercaclima@mgh.harvard.edu. 2. Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts. 3. Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts. 4. Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital Cancer Center, Boston, Massachusetts. 5. Harvard Medical School, Boston, Massachusetts. 6. Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Abstract
PURPOSE: Diagnostic chest CT frequently results in abnormal findings that require follow-up. We assessed the timeliness of follow-up after CT abnormalities were identified in symptomatic smokers at high risk for developing lung cancer. METHODS: In an academic primary care network, we identified current smokers aged 55-79 years who received a diagnostic chest CT to evaluate symptoms during 2012. Medical chart abstraction identified radiologist recommendations and follow-up care. The outcome was the proportion of patients who received timely follow-up (within 30 days of recommendation) after an abnormal chest CT. We assessed for predictors of compliance with recommended follow-up. RESULTS: Of 3,257 eligible smokers, 446 (14%) had a chest CT during 2012. We excluded 70 patients who already had lung cancer, died, had imaging done elsewhere, or left the practice. Of the remaining 376 patients, 337 (90%) had abnormal chest CT findings, and 184 (55%) had a specific follow-up recommendation. Among those with recommended follow-up, only 102 of 184 (55%) had timely follow-up. Those who had a CT performed to evaluate pulmonary disease and those receiving care in community health centers were more likely to receive timely follow-up. Of 27 patients newly diagnosed with lung cancer, 18 (67%) had their first oncology visit within 30 days of diagnosis. CONCLUSIONS: Among patients undergoing diagnostic chest CTs, most received follow-up for abnormal findings, but it was often delayed. Systems to support patients in obtaining recommended follow-up are needed to ensure that the benefits of lung cancer screening translate into usual clinical practice.
PURPOSE: Diagnostic chest CT frequently results in abnormal findings that require follow-up. We assessed the timeliness of follow-up after CT abnormalities were identified in symptomatic smokers at high risk for developing lung cancer. METHODS: In an academic primary care network, we identified current smokers aged 55-79 years who received a diagnostic chest CT to evaluate symptoms during 2012. Medical chart abstraction identified radiologist recommendations and follow-up care. The outcome was the proportion of patients who received timely follow-up (within 30 days of recommendation) after an abnormal chest CT. We assessed for predictors of compliance with recommended follow-up. RESULTS: Of 3,257 eligible smokers, 446 (14%) had a chest CT during 2012. We excluded 70 patients who already had lung cancer, died, had imaging done elsewhere, or left the practice. Of the remaining 376 patients, 337 (90%) had abnormal chest CT findings, and 184 (55%) had a specific follow-up recommendation. Among those with recommended follow-up, only 102 of 184 (55%) had timely follow-up. Those who had a CT performed to evaluate pulmonary disease and those receiving care in community health centers were more likely to receive timely follow-up. Of 27 patients newly diagnosed with lung cancer, 18 (67%) had their first oncology visit within 30 days of diagnosis. CONCLUSIONS: Among patients undergoing diagnostic chest CTs, most received follow-up for abnormal findings, but it was often delayed. Systems to support patients in obtaining recommended follow-up are needed to ensure that the benefits of lung cancer screening translate into usual clinical practice.
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Authors: Sanja Percac-Lima; Jeffrey M Ashburner; Nancy A Rigotti; Elyse R Park; Yuchiao Chang; Salome Kuchukhidze; Steven J Atlas Journal: Cancer Med Date: 2018-02-21 Impact factor: 4.452
Authors: Eduardo R Núñez; Tanner J Caverly; Sanqian Zhang; Mark E Glickman; Shirley X Qian; Jacqueline H Boudreau; Christopher G Slatore; Donald R Miller; Renda Soylemez Wiener Journal: JAMA Netw Open Date: 2021-07-01