Evaluation of CT and MRI scanning among cancer patients in Ontario |
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Authors: | Coburn Natalie Przybysz Raymond Barbera Lisa Hodgson David C Laupacis Andreas Law Calvin |
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Institution: | a Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., Toronto, Ontario, Canada M4N 3M5b Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, Canada M4N 3M5c Princess Margaret Hospital, 610 University Ave., Toronto, Ontario, Canada M5G 2M9d Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael''s Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8 |
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Abstract: | BackgroundComputed tomography (CT) and magnetic resonance imaging (MRI) utilization in Ontario increased drastically since the early 1990s. The effect of an increased number of cancer diagnoses, and an increase in indications for scans has not been assessed. This study was conducted to determine trends in utilization of CT and MRI in cancer patients in Ontario over a period of 9 years.MethodsUsing Ontario Health Insurance Plan billing data linked to the Ontario Cancer Registry, rates of CT and MRI were analyzed by region, year, scan type and socioeconomic status.ResultsCT in cancer patients increased 2.3-fold and accounted for approximately 24% of these scans. MRI in cancer patients increased by 4.2-fold and accounted for approximately 10% of these scans. Imaging rates for cancer patients increased more gradually than that of the general population. Substantial variation in the rate of both scans by region of patient residence existed. Even greater variation by the location of the scanner was demonstrated, indicating that many cancer patients traveled outside their region for imaging. There was little evidence of variation in scanning rates by socioeconomic status.ConclusionA minority of CT and MRI performed in Ontario are for cancer care. Regional variation in imaging rates suggest that utilization guidelines be developed or knowledge transfer initiatives improve compliance to existing guidelines are needed. A significant number of cancer patients travel outside their region for diagnostic imaging; this should influence decisions about the location of new scanners. |
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Keywords: | Computed tomography Magnetic resonance imaging Health services administration Neoplasms Diagnosis |
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