Friday, November 14, 2014

Medicare plans to pay for lung-cancer screening, a boon to Ky.

The Centers for Medicare and Medicaid Services plan to start paying for lung cancer screening with low-dose CT scans for people at high risk.

Spiral CT (computed tomography), which is used to look for lung cancer, is a low-dose form of X-ray that delivers about the same radiation as a mammogram, Maggie Fox reports for NBC News.

“I think after a long effort to get to this point, CMS got it right,” Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance, told Fox. “This has the potential of being one of the most significant cancer mortality-reducing efforts to date. We are finally focusing on what is a quarter of all cancer, and that’s lung cancer.”

Fox reports, "Experts project that the screening test, which costs $250-$300, may prevent as many as 20 percent of future deaths from lung cancer, making it akin to mammograms and colonoscopies in terms of saving lives."

The proposal covers people aged 55-74 who have smoked at least a pack a day for 30 years, or the equivalent. It is now open for a 30-day comment period.

Lung cancer is especially deadly because it usually doesn’t cause symptoms until it’s already spread to other parts of the body. Kentucky has more cases of lung cancer than any other state, and its lung cancer mortality rate is nearly 50 percent higher than the national average. This year alone, 3,500 Kentuckians will die from lung cancer. Nationally, it kills nearly 160,000 people a year, according to the American Cancer Society.

Concerns about using CT scans to screen for ling cancer are that it isn't cheap, it isn't harmless, and the scans aren't always clear, often causing patients to endure further needless testing, Fox reports: "The national lung screening trial showed that for every five to six lives saved by screening, one person died because of procedures done after screening, including surgery and biopsies that collapsed the lung."

That calls for caution. “We strongly advise older current and former heavy smokers to speak with their doctors about whether CT lung cancer screening is right for them,” Dr. Ella Kazerooni, chair of the American College of Radiology Lung Cancer Screening Committee, told Fox. “If they and their doctor decide that screening is warranted, we encourage patients to seek out an ACR lung cancer screening center.” 

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