Repeated CT scans on 12,984 Asians to diagnose lung cancer once it is suspected

Abstract

In Taiwan, lung cancer remains the leading cause of cancer-related fatalities, resulting in substantial healthcare expenses. This research aims to evaluate both the frequency and the costs of low-dose computed tomography (LDCT) in individuals suspected of having lung cancer until their diagnosis of cancer. LDCT screening was not conducted on a population-wide scale, and asymptomatic participants had to cover the expenses for the screening personally or reimburse from other sources. If the screening results were positive or suspicious, National Health Insurance (NHI) could be utilized for subsequent follow-up examinations. This cohort study utilized the NHI Database and focused on individuals with suspected cases of lung cancer identified between 2010 and 2014. A total of 17,572 suspected new lung cancer cases were initially identified and assigned to the relevant International Classification of Diseases codes. Individuals with suspected lung cancer received a diagnosis following an average follow-up period of 2.24 (95%CI, 2.11-2.37) years, and required the use of 2.36 (95%CI, 2.20-2.51) repeated CT scans. The NHI expenditures incurred by the use of CT scans for monitoring suspected lung cancer cases were relatively modest.

Keywords: Asian; cancer screening; computed tomography (CT) scan; cost; lung cancer.

Figure 1

Flowchart demonstrating exclusion criteria and recruited patients. Taiwan’s National Health Insurance Database was used to identify those patients with suspected lung cancer based on ICD code. Those with missing information or a recent cancer diagnosis were excluded. ICD, International Classification of Diseases.

Figure 2

(A) Distribution of computed tomography (CT) exams in those diagnosed with lung cancer vs those deemed to be lung cancer free. (B, C) Follow-up time and number of CT scans used by those diagnosed with lung cancers vs those deemed to be lung cancer free. SD, standard deviation.