Stepped-Up Screening Would Uncover More Lung Cancers
But the scans and follow-up care would be expensive
By Dennis Thompson
WEDNESDAY, May 14, 2014 (HealthDay News) -- New screening guidelines for lung cancer could save tens of thousands of lives, but the CT scans involved will be costly, a new study has found.
Projections show that implementing the guidelines will detect nearly 55,000 more lung cancer cases during a five-year period, most of which would be potentially curable early stage cancers.
But, the cost to Medicare for lung cancer screening and subsequent treatment would be $9.3 billion over five years, which amounts to a $3 per month premium increase for every Medicare member.
"If screening is covered, it's important for Medicare and health care systems to plan for increased demand for CT imaging and early stage treatments -- for example, thoracic surgery and radiation therapy," said study lead researcher Joshua Roth. He is a postdoctoral research fellow with the Fred Hutchinson Cancer Research Center, in Seattle.
"Additionally, Medicare should plan for increased expenditure in the budgeting process," Roth added.
These findings add fuel to an ongoing debate regarding the value of using low-dose CT screening to detect lung cancer in smokers. The study was released Wednesday ahead of the annual meeting of the American Society of Clinical Oncology (ASCO), which begins May 30 in Chicago. It will be formally presented at the meeting on June 2.
Two weeks ago, an advisory panel for the U.S. Centers for Medicare and Medicaid Services (CMS) recommended against Medicare picking up the tab for annual low-dose CT lung cancer screening of older current and former smokers.
"You actually had members saying the money would be better spent and you would impact more lives if you spent it on smoking cessation and smoking prevention," said Dr. Otis Brawley, chief medical officer for the American Cancer Society.
The CMS panel's decision runs counter to the judgment of the U.S. Preventive Services Task Force, which in 2013 recommended CT lung cancer screening for a very specific segment of smokers. The task force recommended annual low-dose CT scans for current and former smokers aged 55 to 79 with at least a 30 pack-year history of smoking who had their last cigarette sometime within the last 15 years. Pack years are determined by multiplying the number of packs smoked daily by the number of years a person has smoked.
Lung cancer is the leading cause of cancer death in the United States, usually because it has spread to other organs in the body by the time it is detected, Roth said.
The U.S. Preventive Services Task Force based its recommendation primarily on the findings from the National Lung Cancer Screening Trial, which demonstrated a 20 percent reduction of lung cancer deaths with CT screening compared to X-ray screening. CT (computed tomography) screening is an imaging procedure that uses special X-ray equipment to create a series of detailed pictures, or scans, of areas inside the body, according to the U.S. National Cancer Institute.