J Am Coll Radiol. 2016 May;13(5):497-504. doi: 10.1016/j.jacr.2016.01.007. Epub 2016 Feb 28.
Percac-Lima S1, Ashburner JM2, Shepard JA3, Lennes IT4, Rimmelin DE5, Atlas SJ6.
PURPOSE:
Diagnostic chest CT frequently results in abnormal findings that require follow-up. We assessed the timeliness of follow-up after CT abnormalities were identified in symptomatic smokers at high risk for developing lung cancer.
METHODS:
In an academic primary care network, we identified current smokers aged 55-79 years who received a diagnostic chest CT to evaluate symptoms during 2012. Medical chart abstraction identified radiologist recommendations and follow-up care. The outcome was the proportion of patients who received timely follow-up (within 30 days of recommendation) after an abnormal chest CT. We assessed for predictors of compliance with recommended follow-up.
RESULTS:
Of 3,257 eligible smokers, 446 (14%) had a chest CT during 2012. We excluded 70 patients who already had lung cancer, died, had imaging done elsewhere, or left the practice. Of the remaining 376 patients, 337 (90%) had abnormal chest CT findings, and 184 (55%) had a specific follow-up recommendation. Among those with recommended follow-up, only 102 of 184 (55%) had timely follow-up. Those who had a CT performed to evaluate pulmonary disease and those receiving care in community health centers were more likely to receive timely follow-up. Of 27 patients newly diagnosed with lung cancer, 18 (67%) had their first oncology visit within 30 days of diagnosis.
CONCLUSIONS: Among patients undergoing diagnostic chest CTs, most received follow-up for abnormal findings, but it was often delayed. Systems to support patients in obtaining recommended follow-up are needed to ensure that the benefits of lung cancer screening translate into usual clinical practice. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.