Surveillance Practice Patterns after Curative Intent Therapy for Stage I Non-Small-Cell Lung Cancer in the Medicare...

Area of Science:

• Oncology
• Medical Imaging
• Health Services Research

Background:

• Recurrence is common after non-small cell lung cancer (NSCLC) treatment, necessitating routine imaging surveillance.
• Evidence-based guidelines recommend surveillance, but patterns after curative intent therapy for early-stage NSCLC are not well understood.

Purpose of the Study:

• To investigate recent practice patterns for surveillance of stage I NSCLC.
• To assess adherence to guidelines in the first two years post-treatment in the Medicare population.

Main Methods:

• Utilized the SEER-Medicare linked database for patients diagnosed with stage I NSCLC (1998-2008).
• Evaluated adherence to guidelines for chest radiography and CT scans.
• Tracked the use of non-recommended PET scans.
• Employed logistic regression to identify factors associated with guideline adherence.

Main Results:

• Only 61.4% of patients received guideline-adherent surveillance in the first two years.
• CT scan use increased significantly from 1998 to 2008 (47.4% to 78.5%).
• Positron Emission Tomography (PET) scan use rose from 5.8% to 28.9% during the same period.
• Adherence was linked to younger age, higher income, more comorbidities, primary care access, and SBRT treatment.

Conclusions:

• Adherence to surveillance guidelines for stage I NSCLC in Medicare beneficiaries is suboptimal.
• Less than two-thirds received recommended imaging, and nearly 30% underwent non-recommended PET scans.