Utilization of CT and MRI scanning among cancer patients in Ontario, 1993-2002

Coburn N, Przybysz R, Law C, Barbera L, Hodgson D, Sharir S, Laupacis A
Record ID 32006000011
Authors' objectives:

The purpose of this study is to determine the utilization of CT and MRI resources by cancer patients in Ontario, during the period from 1993 to 2002.

Authors' results and conclusions: Key Findings - The findings indicate that the use of computerized tomography (CT) scans in cancer patients has increased 2.3-fold over the nineyear period considered in the study, while magnetic resonance imaging (MRI) scans in cancer patients increased by 4.2-fold during the same period. - The rate of CT and MRI for cancer patients increased at a lesser rate than that of CT and MRI scans in the general population. - There was significant variation in the rate of utilization of CT and MRI when examined by the local health integration network (LHIN) in which patients reside. - When compared to the location of the scanner, there was even greater variation, suggesting that many patients are traveling outside of their LHIN for both imaging and cancer care. - Further areas of examination raised include the possibility of under-/over-utilization of scanning at the disease-specific level. - In general, the data suggest that there were appropriate rates of CT and MRI scans ordered for the top five cancers in Ontario as a whole. - Cancer patients comprise a small percentage of the overall users of CT and MRI technologies in Ontario, which suggests that delays in their access to CT and MRI scans may be caused, at least in part, by the use of the equipment for other indications. - A significant number of cancer patients travel outside of their LHIN for diagnostic imaging, which impacts decisions regarding resource allocation, including geographical location of equipment and utilization patterns.
Authors' recommendations: Variations in CT and MRI utilization rates at the disease-specific and LHIN levels suggest the need to develop initiatives and approaches to improve compliance with existing imaging utilization guidelines for all cancer groups, and to develop new guidelines - an initiative currently being undertaken by Cancer Care Ontario (CCO). Evaluation of compliance could be undertaken by ICES, provided that data related to tumour size and staging of the cancer are available. In addition, differences in utilization between LHINs and patient migration to different LHINs will need to be studied further. However, current patterns of travel to different LHINs for CT and MRI scans should be considered when planning the location of new CT and MRI scanners.
Authors' methods: Overview
Project Status: Completed
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Neoplasms
  • Magnetic Resonance Imaging
  • Tomography, X-Ray Computed
Organisation Name: Institute for Clinical Evaluative Sciences
Contact Address: Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, G-Wing, Toronto ON, Canada, M5N 3M5. Tel: 416-480-4055; Fax: 416-480-6048
Contact Name: info@ices.on.ca
Contact Email: info@ices.on.ca
Copyright: Institute for Clinical Evaluative Sciences (ICES)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.