(ChemotherapyAdvisor) – Long-term survivors of young adult malignancies receive significantly higher rates of all diagnostic imaging studies compared to their age-matched cancer-free counterparts, results of a population-based retrospective study reported during ASCO’s inaugural Quality Care Symposium in San Diego, CA.
“For the past several years, clinical practice guidelines have recommended decreasing the amount of surveillance in adolescent and young adult cancer survivors,” said Jyoti Patel, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, and a member of the ASCO Cancer Communications Committee.
“Unfortunately, we are still seeing overuse of diagnostic imaging, which is associated with increased anxiety about test results and unnecessary radiation exposure. To mitigate this problem, we are educating internists, general physicians, and patients about overuse of scans.”
Corinne Daly, BSc, MSc, of the Institute of Medical Science, University of Toronto, Ontario, Canada, and colleagues identified 20,911 young adults aged 20 to 44 years in the Ontario Cancer Registry diagnosed with an invasive malignancy between 1992 and 1999 who lived at least 5 years without recurrent disease. This cohort was matched (1:5) to 104,524 randomly selected cancer-free controls on calendar year of birth, sex, and place of residence. Rates of receipt of plain radiography, CT, ultrasound, and nuclear medicine studies were compared between the two groups.
In the 10-year period following 5-year recurrence-free survival, the young adults received all types of diagnostic imaging at significantly higher rates than controls. Rate of CT scanning was 3.6-fold higher than controls (95% CI 3.37–3.62), as were plain radiography (RR 1.66; 95% CI 1.64–1.69) and nuclear studies (RR 1.97; 95% CI 1.89–2.04), resulting in a 4.6-fold adjusted higher diagnostic radiation dose than controls.
Difference in rates of ultrasound between the two groups was more modest (RR 1.40; 95% CI 1.38–1.43), she reported.