OBJECTIVES: The transition to cancer survivorship care, specifically surveillance for recurrence, is an important consideration in earlier-staged LC, where 5-year recurrence rates are between 30-50%. While surveillance guidelines have been developed, real-world evidence is limited. The objective of this study was to describe LC survivor surveillance patterns in a real-world setting.

METHODS: A retrospective analysis was conducted using Optum’s de-identified Integrated Claims-Clinical dataset with Enriched Oncology. Adult patients diagnosed with stage I-III LC between 1/1/2016-6/30/2020, initiated cancer treatment ≤365 days from diagnosis with ≥60 treatment-free days after completion of treatment were included. Surveillance use included X-ray, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET/PET-CT), and low-dose CT (LDCT). Surveillance patterns were evaluated by stage and year, with Kaplan-Meier estimates of time to first imaging.

RESULTS: A total of 1,154 LC patients were eligible with a mean (SD) age of 70.7 (9.6), 68.8 (9.6), and 68.8 (9.6) years for Stage I, II and III patients, respectively. CT use for stage I, II, and III at 6/12 months following active treatment were 72%/90%, 76%/86%, and 62%/72%, respectively. Within 12-months post treatment, X-ray use ranged from 46 to 69% while PET/ PET-CT use ranged from 21 to 38%, across stages, while MRI and LDCT use were <6% and <1%, respectively. Utilization of any form of imaging for stages I, II and III at 6 months was 85%, 87%, and 75%, and at 12 months increased to 96%, 93% and 77%, respectively. Compared to year 1, imaging declined in years 2 and 3, across stages.

CONCLUSIONS: Consistent with guidelines, CT was the most common, however, a quarter of patients did not have a CT within 6 months of completion of active treatment, as recommended. Improvements in cancer survivorship surveillance may enable improved outcomes in LC survivors.