title: Trends in diagnostic CT among fee-for-service enrollees, 2000-2011.
abstract: OBJECTIVE
  To examine trends in the use of diagnostic CT in aggregate and for 4 major body regions (abdomen/pelvis, head/neck, chest, and spine) in an 11-year US nationwide analysis.
  
  
  METHODS
  We summarize records from a large, mostly fee-for-service insurance claims database from 2000 to 2011.
  
  
  RESULTS
  Rates of diagnostic CT have increased substantially from 2000 to 2011; however, changes in rates are disparate for different age groups and body regions. As others have shown, there has been a notable increase in use of diagnostic CT from 2000 to 2011. However, from 2009 to 2011, diagnostic CT studies of the chest, abdomen/pelvis, and head/neck have leveled off or decreased, whereas CTs of the spine show a continued increase in many groups.
  
  
  CONCLUSIONS
  In general, the increase in the rate of CT study performance has slowed, whereas spine CT continued to escalate. Future research should consider whether the increase in use of spine CT leads to a benefit that outweighs the risk associated with the increased population-level cancer risk.
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France. Electronic address: hamrag@fellows.iarc.fr.
authors.forename: Ghassan B
authors.initials: GB
authors.lastname: Hamra
authors.affiliation: Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
authors.affiliation: Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Lauren M B
authors.initials: LM
authors.lastname: Burke
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Virginia
authors.initials: V
authors.lastname: Pate
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: M Alan
authors.initials: MA
authors.lastname: Brookhart
mesh_terms: D018588:Fee-for-Service Plans / Q000191:economics* / Q000639:trends*; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000639:trends*; D011871:Radiology / Q000191:economics / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000639:trends*; D014481:United States
keywords: CT; diagnostic radiology; radiation exposure; trends