Medicare Will Cover Screenings for High Risk Lung Cancer Patients
This week, Medicare announced it was going to pay for annual CT scans for older patients who are considered high risk for lung cancer. The proposal – which won’t be final until February – will cover an estimated four million people, many of whom are at greatest risk for the disease.
Malcolm DeCamp, MD, chief of the division of thoracic surgery at Northwestern Memorial Hospital, is relieved to hear the decision, which was not considered to be a sure thing. This spring a government advisory panel composed mostly of medical experts expressed some misgivings that the benefit of screenings would outweigh potential harms.
“This is a life-saving procedure that should be a covered service,” said DeCamp, who is also the McCormick Professor of Surgery at the Northwestern University Feinberg School of Medicine. “There is no question in my mind that this decision will save lives."
Lung cancer claims about 160,000 American lives a year — more than a quarter of all cancer deaths and greater than the toll from colorectal, breast, pancreatic and prostate cancers combined. It is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women.
“We need to embed the practice of CT screenings for lung cancer into routine preventative care, just like mammograms and colonoscopies, realizing that more Americans die of lung cancer than these other common cancers combined,” DeCamp said. “Each of these screening tests are and should be continuously refined to decrease risks and CT screening for lung cancer is no different.”
Like most cancers, the earlier lung cancer is detected, the better chance the patient has of survival. Low-dose CT scans can help find tumors before symptoms occur and while they are still treatable.
“If a patient thinks he or she may fall into the high risk category, that patient should have a discussion with their doctor,” said Eric M. Hart, MD, a radiologist and associate professor of radiology at the Feinberg School. “CT scans of the chest provide more detailed pictures than chest x-rays and are better at finding small abnormalities before lung cancer symptoms occur. Typically symptoms of lung cancer don’t appear until the disease is an advanced stage so catching it early on a CT scan can potentially improve a patient’s survival rate.”
To qualify for a screening, patients would have to first meet with a doctor to talk through the pros and cons of scans, which involve a low-dose of radiation.
To qualify, patients would have to be:
- Between the ages 55 and 74;
- Have no symptoms of lung disease;
- Have smoked the equivalent of 30 pack-years (or a pack a day for 30 years);
- And be a current smoker or have given it up in the past 15 years.