Ran Guo1,2,3, Yang Zhang1,2,3, Zelin Ma1,2,3, Chaoqiang Deng1,2,3, Fangqiu Fu1,2,3, Hong Hu1,2,3, Yihua Sun1,2,3, Haiquan Chen4,5,6. 1. Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. 2. Institute of Thoracic Oncology, Fudan University, Shanghai, 200032, China. 3. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. 4. Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, 270 Dong-An Road, Shanghai, 200032, China. hqchen1@yahoo.com. 5. Institute of Thoracic Oncology, Fudan University, Shanghai, 200032, China. hqchen1@yahoo.com. 6. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. hqchen1@yahoo.com.
Abstract
PURPOSE: Although professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients still undergo unnecessary Chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients. METHODS: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up period, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening. RESULTS: Among 1853 patients in the study, 689 (37.2%) overused Chest CT during follow-up of the pulmonary nodules. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P < 0.001). 50.7% in the "age ≤ 40" group, 39.8% in the "41 ≤ age ≤ 50" group, 38.7% in the "51 ≤ age ≤ 60" group, 32.3% in the "61 ≤ age ≤ 70" group, 27.8% in the " > 70" group underwent unnecessary CT (P < 0.001). Female got more unnecessary CT than male (40.6% vs 32.8%, P < 0.001). Factors associated with a greater likelihood of overusing Chest CT was the density of nodules [odds ratios (ORs) of 0.53 for mGGO; 0.15 for solid nodule, P < 0.0001, vs patients with pGGO]. CONCLUSION: Roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.
PURPOSE: Although professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients still undergo unnecessary Chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients. METHODS: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up period, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening. RESULTS: Among 1853 patients in the study, 689 (37.2%) overused Chest CT during follow-up of the pulmonary nodules. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P < 0.001). 50.7% in the "age ≤ 40" group, 39.8% in the "41 ≤ age ≤ 50" group, 38.7% in the "51 ≤ age ≤ 60" group, 32.3% in the "61 ≤ age ≤ 70" group, 27.8% in the " > 70" group underwent unnecessary CT (P < 0.001). Female got more unnecessary CT than male (40.6% vs 32.8%, P < 0.001). Factors associated with a greater likelihood of overusing Chest CT was the density of nodules [odds ratios (ORs) of 0.53 for mGGO; 0.15 for solid nodule, P < 0.0001, vs patients with pGGO]. CONCLUSION: Roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.
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