Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2019 Dec;82(12):948-956. doi: 10.1097/JCMA.0000000000000199.
The trends in computed tomography (CT) scan uses in Taiwan were examined in different age and sex groups and compared between catastrophic illness and noncatastrophic illness groups.
This retrospective cohort study used data from the National Health Insurance Research Database (NHIRD) in Taiwan to analyze CT scan uses from the beginning of 2000 to the end of 2013. The number, annual growth rate, and cumulative fold change ratio were estimated in different groups classified by sex, age, or disease category (catastrophic illness, noncatastrophic illness).
The number of CT scan uses per million people per year in Taiwan increased 2.5 times from 24 257 in 2000 to 60 351 in 2013, at the average annual growth rate of 7.4% ± 5.9%. The annual number of CT scan uses in different age groups and disease category groups was significantly higher in males than in females. However, the average annual growth rate and the cumulative fold change ratio were slightly higher in females than in males. The majority of CT scan uses were in middle age and young adult groups. The annual number of CT scan uses in the young adult, child/adolescent, and middle age groups increased 3.7-, 3.5-, and 2.7-fold from 2000 to 2013, but decreased 0.8-fold in the old-age group. The annual number of CT scan uses was highest in the noncatastrophic illness group, followed by the catastrophic illness cancer group and catastrophic illness others group.
CT scan uses in Taiwan increased continuously from 2000 to 2013, even in the groups with higher radiation-related cancer risk. Therefore, clinicians, radiologists, and medical policy makers should weigh diagnostic benefit against sex-specific and age-specific risks in the future.
本研究旨在探讨台湾地区不同年龄和性别组别的计算机断层扫描（CT）使用趋势，并比较灾难性疾病和非灾难性疾病组之间的差异。
本回顾性队列研究使用了来自台湾全民健康保险研究数据库（NHIRD）的数据，对 2000 年初至 2013 年底的 CT 扫描使用情况进行了分析。根据性别、年龄或疾病类别（灾难性疾病、非灾难性疾病）对不同组别的人数、年增长率和累积折叠变化比进行了估计。
台湾地区每百万人每年的 CT 扫描使用量从 2000 年的 24257 例增加到 2013 年的 60351 例，年均增长率为 7.4%±5.9%。不同年龄组和疾病类别组的 CT 扫描使用人数男性明显高于女性，但女性的年均增长率和累积折叠变化比略高于男性。大多数 CT 扫描使用集中在中年和青年群体。2000 年至 2013 年，青年、儿童/青少年和中年组的 CT 扫描使用量年增长率分别为 3.7 倍、3.5 倍和 2.7 倍，但老年组的 CT 扫描使用量则下降了 0.8 倍。非灾难性疾病组的 CT 扫描使用量最高，其次是灾难性疾病癌症组和灾难性疾病其他组。
从 2000 年到 2013 年，台湾地区的 CT 扫描使用量持续增加，即使在辐射相关癌症风险较高的组中也是如此。因此，未来临床医生、放射科医生和医疗政策制定者应权衡诊断获益与性别和年龄特异性风险。
