Sarcoma-suspected incidental imaging findings often irrelevant while posing significant financial burden
Incidental findings, suspected of being a rare type of cancer, are often irrelevant, with unnecessary follow-up tests posing a significant financial burden to patients and the healthcare system.
That’s according to a new analysis from Dutch imaging experts, published Sunday. Such sarcomas are uncommon, occurring fewer than 5 times per 1 million individuals, with the vast majority located in the soft tissue.
Providers suspecting sarcoma may send patients to centers specializing in this clinical concern for further testing. However, more than 10% of these referrals end up being benign or of low-risk malignant potential, experts reported in Clinical Imaging. On average, each case tallies about $2,155 in unnecessary downstream healthcare costs while also subjecting patients to potential psychological distress and complications stemming from unnecessary invasive procedures.
“Our results demonstrate that incidentalomas that are referred to a specialized sarcoma center and that turn out to be benign or of low-risk malignant potential pose a considerable financial burden to patients and the healthcare system,” Thomas Kwee MD, PhD, with the Department of Radiology at University Medical Center Groningen, the Netherlands, and colleagues wrote March 6. “Because these incidentalomas can be considered clinically irrelevant, we believe that there is no benefit in detecting them and that they only represent costs rather than benefits,” they added later.
Kwee et al. conducted their study using data from an unnamed healthcare organization operating in a region with more than 3 million inhabitants. Their analysis included all consecutive new patients, referred to the institution’s specialized sarcoma center during a seven-month period. A total of 221 subjects were included in the retrospective study, and 28 experienced an incidental imaging finding. Providers deemed 11 benign and 12 low-risk for malignancy for the final count of 10.4%.
Use of radiography or CT were significantly more associated with such clinical findings when compared to ultrasonography, Kwee and colleagues noted. Other factors—such as patient age, gender, history of malignancy, or specialty who detected the lesion—did not impact patients’ odds of experiencing these incidentalomas. Altogether, the 23 cases resulted in a total of nearly $50,000 in unnecessary downstream healthcare costs.
“Given the sharply increasing costs of healthcare in the Western world, including the <BLINDED>, they should be a target for cost savings,” Kwee and co-authors advised. “Healthcare professionals should take responsibility to ‘image wisely,’ reduce overutilization of imaging services, and avoid overdiagnosis.”
Read more in the New York Roentgen Society’s official journal here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.