CT screening for comorbid disease in patients with prostatic carcinoma: is it cost-effective?

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Abstract
The role of imaging in patients with newly diagnosed prostatic carcinoma is controversial. Currently, 35% of patients with prostatic carcinoma undergo CT at the time of diagnosis, despite reports of the lack of efficacy of CT in staging the disease. We sought to evaluate the cost-effectiveness of CT in detecting unrelated comorbid disease (significant disease unrelated to prostatic carcinoma) that might affect decisions on treatment in this population of patients.We reviewed the medical records of 273 consecutive patients with newly diagnosed prostatic carcinoma who had CT of the abdomen and pelvis as part of their preoperative evaluation. Using costs based on Medicare reimbursements, we assessed the impact of the CT findings (related to comorbid disease) on overall costs and savings related to the workup and treatment of these patients.Sixty-six patients (24%) had findings suggestive of comorbid disease. The CT findings had near-term impact on only four patients (two in whom large abdominal aortic aneury...

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