A follow-up survey of participants and their physicians supported the conclusion that a community memory-screening program might detect individuals who were previously unknown to have cognitive problems. Furthermore, such a program was highly acceptable to participants. The small number of individuals diagnosed with dementia as a result of the screening program indicates that this form of screening may be inefficient as performed. Multiple obstacles to seeking follow-up care were identified and would need to be addressed in larger-scale programs to make this a worthwhile endeavor. The experience gained in this memory screening program might aid in the planning of better programs, which will be essential if early diagnosis is to keep pace with the growth of treatments for dementia.
Objective
To investigate the cost and impact of routine preoperative computed tomography (CT) in patients with high‐grade endometrial cancer, and its role in identifying extrauterine disease.
Methods
We retrospectively identified patients with high‐grade endometrial cancer who underwent routine CT scan prior to surgical procedure between September 1, 2005, and January 31, 2015. Cases in which CT findings led to alterations in the treatment plan were documented. Incidental findings unrelated to endometrial cancer diagnosis were captured. Cost of imaging and diagnostic procedures was based on Ontario's Physician Services–Schedule of Benefits.
Results
Of 179 patients included, 57 (31.9%) were diagnosed with stage 3–4 disease. CT showed evidence of metastatic disease in 30 (16.8%) patients; however, planned surgical procedure was altered in only nine (5.0%) cases. CT results showed incidental findings requiring follow‐up in 78 (43.6%) cases, three of which were second malignancies. We estimate an expenditure of CAD$14 185.85 on routine imaging for every case in which surgical management was changed.
Conclusions
Preoperative CT imaging is efficacious in identifying extrauterine disease in patients with high‐grade endometrial cancer, although it seldom alters surgical management. Many of these CT scans will identify incidental findings requiring further interventions, resulting in substantial costs.
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