Inessa A Goldman1, Alain Cunqueiro1, Meir H Scheinfeld2. 1. Montefiore Medical Center, Department of Radiology, Division of Emergency Radiology, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY, 10467, USA. 2. Montefiore Medical Center, Department of Radiology, Division of Emergency Radiology, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY, 10467, USA. mscheinf@montefiore.org.
Abstract
PURPOSE: The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types of new CT-based torso cancer diagnoses in the ED. METHODS: A total of 19,496 CT reports including all or parts of the torso from 2017 were searched for the keywords: "mass", "tumor", "neoplasm", "malignancy", or "cancer". Each report and corresponding medical record was evaluated for presence of a new cancer. Cases were scored as no cancer, subcentimeter lung nodule, known cancer, new cancer, or suspicious, but unconfirmed for new cancer. Each mass was characterized as symptom-related or incidental. RESULTS: At least one keyword was found in 2086 reports. Of these 706, 126 and 905 were known cancer cases, subcentimeter lung nodules, and non-cancerous cases, respectively. There were 251 confirmed new cancers and 98 suspicious cases which lacked adequate diagnostic workup. Depending on whether only definite or definite and suspicious cases were included together, the number of new cancer cases per 100 torso CT exams was 1.3 or 1.8, respectively. Gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers were most common. Only 58 of the confirmed cases (23%) were deemed as incidental findings. CONCLUSION: CT-diagnosis of new torso cancers was uncommon in our setting. Still, while extensive knowledge of cancer staging may not be necessary for ED radiologists, knowledge of the most common types of cancer including gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers may improve sensitivity for these diagnoses and may expedite appropriate referrals for the newly diagnosed patients.
PURPOSE: The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types of new CT-based torso cancer diagnoses in the ED. METHODS: A total of 19,496 CT reports including all or parts of the torso from 2017 were searched for the keywords: "mass", "tumor", "neoplasm", "malignancy", or "cancer". Each report and corresponding medical record was evaluated for presence of a new cancer. Cases were scored as no cancer, subcentimeter lung nodule, known cancer, new cancer, or suspicious, but unconfirmed for new cancer. Each mass was characterized as symptom-related or incidental. RESULTS: At least one keyword was found in 2086 reports. Of these 706, 126 and 905 were known cancer cases, subcentimeter lung nodules, and non-cancerous cases, respectively. There were 251 confirmed new cancers and 98 suspicious cases which lacked adequate diagnostic workup. Depending on whether only definite or definite and suspicious cases were included together, the number of new cancer cases per 100 torso CT exams was 1.3 or 1.8, respectively. Gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers were most common. Only 58 of the confirmed cases (23%) were deemed as incidental findings. CONCLUSION: CT-diagnosis of new torso cancers was uncommon in our setting. Still, while extensive knowledge of cancer staging may not be necessary for ED radiologists, knowledge of the most common types of cancer including gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers may improve sensitivity for these diagnoses and may expedite appropriate referrals for the newly diagnosed patients.
Entities:
Keywords:
CT; Cancer diagnosis; Cancer incidence; Diagnosis; Emergency department
Authors: David B Larson; Lara W Johnson; Beverly M Schnell; Shelia R Salisbury; Howard P Forman Journal: Radiology Date: 2010-11-29 Impact factor: 11.105
Authors: Marcos D Guimaraes; Almir G V Bitencourt; Edson Marchiori; Rubens Chojniak; Jefferson L Gross; Vikas Kundra Journal: Cancer Imaging Date: 2014-04-29 Impact factor: 3.909
Authors: Zhi Yang; Runxiang Yang; Min Ji Kwak; Aiham Qdaisat; Junzhong Lin; Charles E Begley; Cielito C Reyes-Gibby; Sai-Ching Jim Yeung Journal: PLoS One Date: 2018-02-20 Impact factor: 3.240
Authors: Annie Herbert; Gary A Abel; Sam Winters; Sean McPhail; Lucy Elliss-Brookes; Georgios Lyratzopoulos Journal: J Epidemiol Community Health Date: 2018-11-08 Impact factor: 3.710
Authors: Donna R Rivera; Lisa Gallicchio; Jeremy Brown; Benmei Liu; Demetrios N Kyriacou; Nonniekaye Shelburne Journal: JAMA Oncol Date: 2017-10-12 Impact factor: 31.777