Routine CT scans after a non-Hodgkin’s lymphoma are often not necessary, but can be harmful to the asymptomatic patient due to a small but cumulative risk of radiation-induced malignancies. A CT scan is costly, can be harmful and increase patient uncertainty. Additionally, there is no improved survival by routinely performing these CTs. Routine CT scans should no longer be performed in the follow up of malignant lymphomas. Follow-up should be based on symptomatology, physical examination (lymphadenopathy) and laboratory tests.
This project aims to reduce unnecessary follow-up CT scans in patients after curative treatment of malignant lymphoma.
The barriers and facilitators were identified using online surveys. Among hematologists, the ordering behavior of imaging in patients with a lymphoma was questioned as well as the reasons for requesting this imaging. An online survey among patients with lymphoma looked at what patients expect from a consultation during follow-up and why patients seem to attach so much value to imaging.
The amount of imaging performed in patients with lymph node cancer was assessed using the DHD database. Subsequently, a training course was started among hematologists and a brochure for patients was developed and spread. The effect of these strategies was measured again with the help of the financial database of the DHD.
Looking at the average number of scans that a patient receives per year, data shows that more scans are performed in the region in which this study was performed compared to national data. So there is certainly room to reduce imaging within this region. In the first intervention year 2017, the number of scans in the intervention group decreased with 8.5% and 1.8% in the control group compared to 2016. In particular, the reassuring effect of a scan was identified by both doctors and patients as the main reason why imaging is nevertheless performed.
At the moment, this project is being completed.