por John R. Fischer
, Senior Reporter | July 15, 2020
Approximately two-thirds of oncologic imaging was performed in non-academic practices in 2016, aligning with data from the National Cancer Institute that indicates that the majority of cancer care takes place in community settings. The share of imaging that was oncologic, however, was higher in academic than in nonacademic practices, and in physician offices and hospital outpatient offices, compared to inpatient or ED settings.
The authors also observed geographic discrepancies in percentages of advanced oncologic imaging, with Arkansas holding the highest rate at 15.3% in 2016, while Wyoming had the lowest at 4.9%. Utilization was highest in Washington, D.C. at 162 exams per 1,000 Medicare beneficiaries and again, lowest in Wyoming, at a rate of 25 per 1,000.
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The share of advanced imaging that was oncologic varied by state and did not correlate with geographic variations in cancer prevalence or radiologist supply. While state-level utilization of oncologic advanced imaging also did not correlate with cancer prevalence, it did do so significantly with radiologist supply.
Among the authors’ suggestions for addressing these issues is the creation of physician networks that can provide second opinions; and the creation of some form of accreditation or certification, as well as maintenance-of-certification pathways. They also encourage greater investment in AI and telemedicine technologies for mentoring and peer learning.
"The incidence of cancer in the United States is rising, and while improvements in cancer care have reduced overall cancer mortality, not all populations are benefiting equally," said Hricak. "Outcomes vary substantially depending on the care setting and patients' insurance status, race and ethnicity, with many patients not receiving the care recommended by national guidelines. Artificial intelligence and telemedicine will help tremendously by improving the implementation of guidelines for imaging and treatment, streamlining patient workflow, assisting with rapid and accurate image interpretation, and making it easier to get second opinions and consultations. For improving cancer care in rural areas, telemedicine will be absolutely essential."
The findings will be published in the Journal of the American College of Radiology
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