Monday, July 29, 2013

Federal task force gives thumbs up for CT screens for lung cancer

ROCKVILLE, MD – Smokers got a double boost today in heading off their risk of dying from lung cancer. The U.S. Preventive Services Task Force (USPSTF), a panel of experts who examine the value of a variety of screening methods and the guidelines for using them, gave a thumbs up to using a yearly CT scan to screen for lung cancers.

The guidelines the task force approved are for adults ages 55-79 who have 30 pack years of smoking or who have quit within the last 15 years. A pack year is smoking a pack of cigarettes a day for one year. So if you smoke two packs a day for 15 years, you would have a 30-pack-year smoking history.

MedPage Today reported that the new guidelines are expected to prevent one lung cancer death for every 320 people screened. By comparison mammography is expected to prevent one death per every 1,905 women 40-49 who are screened, or one per every 1,339 women ages 50-59.

The second boost came from the Task Force giving the screening method a grade B, which basically means this is a high-value screening method. The significance of this is that under the Affordable Care Act, or Obamacare, insurance companies are required to cover any screening method that is given an A or B grade by the USPSTF. That will open up the expensive procedure to many more smokers, particularly as uninsured people begin to enroll in the insurance exchanges that begin in October.

The out-of-pocket cost for the CT screen range from $50 to $400 according to Dr. Dan Raz, surgical director of lung cancer and thoracic oncology at City of Hope medical center in Duarte California. He told MedPage Today the cost could be a huge barrier for people.

The guidelines have been a long time coming as CT scans were first suggested as a screening method in 1996, but due to the high cost and lack of evidence supporting the strategy the USPSTF recommended against it then, and again in 2004. An actuarial firm that analyzed the costs of the screening earlier this year showed that the cost per life-year saved would be about $19,000, which is similar for colorectal cancer screening, and less expensive than screening for breast cancer and cervical cancer. 

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