Older smokers and former smokers are well aware that they are at increased risk for a deadly lung cancer. On July 29, a government panel recommended that these individuals should undergo annual CT scans for lung cancer; they suggested that early detection of the leading cause of cancer deaths in LA as well as the rest of the nation could save more than 20,000 lives every year.
This recommendation was based on the finding of the National Lung Screening Trial, which was first published online on June 29, 2011 in the New England Journal of Medicine. Researchers at UCLA’s Jonsson Comprehensive Cancer Center participated significantly in the research. The study was conducted on individuals at high risk of developing lung cancer to compare the differences in death rates between smokers aged 55 to 74 who were screened annually with low-dose helical (or spiral) CT, versus the conventional chest X-ray. Dr. Denise R. Aberle, national principal investigator for 23 of the 33 NLST sites and a researcher with UCLA’s Jonsson Comprehensive Cancer Center, said this publication provides a more extensive analysis of the data than was initially reported in November 2010, and offers further definitive evidence of a significant mortality benefit from CT screening. “These findings confirm that low dose CT screening can decrease deaths from lung cancer, which is expected to kill more than 150,000 Americans this year alone,” said Dr. Aberle. She added, “This study also will provide us with a road map for public policy development in terms of lung cancer screening in the years to come.”
The recommendation, by the US Preventive Services Task Force, note that individuals aged 55 to 79 with a lengthy history of at least moderate smoking should be screened if they have smoked in the past 15 years. That population is most at risk for lung cancer and would get significant benefits while experiencing relatively little harm from the low-dose radiation used in chest CT scans, and from false positive tests. The average national cost of a chest CT scan is $750; however, under the terms of many health insurance companies as well as the Affordable Care Act, the test would be covered, possibly with a nominal co-pay. No co-pay would be required under the terms of the Affordable Care Act. A spokesman for the Department of Health and Human Services said that if the recommendation becomes final after a public comment period, coverage would begin no sooner than a year later, with the start of each new insurance plan year. Thus, if the recommendation were finalized by the end of 2013, coverage would go into effect at the start of a plan year that begins in January 2015. As reported in the Wall Street Journal, “The link to the Affordable Care Act is a very big deal,” said Robert Smith, director of cancer screening for the American Cancer Society. He predicted an increase in physician referrals for lung cancer tests as a result of the new recommendation. Another group, the Lung Cancer Alliance, went further. Its president and CEO, Laurie Fenton Ambrose, called the recommendation a “monumental moment” in the battle against lung cancer.
The US Preventive Services Task Force is an independent panel of experts that issues recommendations to healthcare providers, the federal government, and the public. About 85% of all lung cancers are attributable to first- and secondhand tobacco smoke. Nine years ago, the panel determined that there was not enough information to recommend routine lung cancer screenings for smokers or former smokers. However, following the release of the results of the National Lung Screening Trial, which compared the effectiveness of low-dose CT scans with chest X-rays in detecting cancer among more than 53,000 current and former heavy smokers. The study found that those who received CT scans had a 20% lower risk of dying from lung cancer.