The US Preventative Services Task Force strikes again. On Monday, the non-government panel issued a draft recommendation that heavy smokers should undergo yearly chest CT scans in order to screen for lung cancer.
The draft recommendation is a huge change in policy for the panel, which previously recommended against routine CT scanning. The previous recommendation was based on inadequate data to demonstrate a benefit for lung cancer screening given that the current screening method with chest Xray still fails to identify a large number of cancers that could be treated with surgery.
But CT scans have a higher sensitivity for identifying smaller lesions than chest Xray. The price of the average CT scan has declined over time, and a large-scale clinical trial from the National Cancer Institute found that CT scans reduced lung cancer mortality by 16% for the highest risk patients. The trial enrolled over 53,000 patients.
The potential benefit of the recommendation could be some 20,000 lives a year. Lung cancer is currently the second most common cancer for both men and women, but is the leading cause of cancer deaths for both men and women at roughly 160,000 lives a year. That’s more than colorectal, breast, pancreatic and prostate cancers combined. Nearly 90 percent of patients with lung cancer die from it, in part because it is discovered too late.
The USPSTF has given the draft recommendation a “B” grade, meaning that it is strongly recommended. Any recommendations with an “A” or “B” grade must be covered under the Affordable Care Act with no out of pocket payment to the patient – meaning no copay. Additionally, Medicare would have to start covering the scans. And that could mean savings for these high risk patients.