Nationwide Lung Cancer Screening Could Find More Early-Stage Cancers, but at an Increased Cost

ASCO Annual Meeting
May 14, 2014

A new model predicts that nationwide lung cancer screening for people enrolled in Medicare who have a high risk of the disease would double the percentage of early-stage lung cancers diagnosed over five years. In March 2014, the U.S Preventive Services Task Force (USPSTF) recommended that people age 55 to 80 with a high risk of lung cancer due to cigarette smoking receive screening for the disease each year with low dose computed tomography (CT).  A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine to find any abnormalities or tumors. People considered to have a high risk of lung cancer include current tobacco smokers who have smoked an average of one pack of cigarettes a day for at least 30 years or those who have quit within the past 15 years.

Researchers looked at three different screening use scenarios for implementing the recommendations. The expected screening use scenario is based on historic experience with mammography, in which 50% of patients that are offered screening each year actually receive screening. In the low-use scenario, 25% of patients that are offered screening each year receive screening. For the high-use scenario, 75% of patients offered screening would receive screening each year. The high-use screening scenario would find the most early-stage lung cancers, but would be challenging to implement because of the resources needed to follow this approach.

Researchers found that following the USPSTF recommendations with the expected screening use scenario would result in 54,900 more lung cancer diagnoses over five years than no screening. It would also increase the percentage of lung cancers diagnosed at an early stage from the current 15% to 33%. However, they also estimate that screening would increase Medicare premiums by $3.00 per month. For the low-use scenario, researchers estimated that Medicare premiums would increase by $1.90 per month. For the high-use scenario, that increase would be $4.10 per month.

What this means for patients

“If we can diagnose lung cancers at an earlier stage, patients can be treated far more effectively and the chance of survival is much better,” said lead study author Joshua A. Roth, PhD, MHA, a postdoctoral research fellow at Fred Hutchinson Cancer Research Center in Seattle, WA. “However, the key to the success of this screening program is ensuring that those who are at high risk actually undergo screening and receive appropriate treatment.”

Questions to Ask Your Doctor

  • What is my risk of lung cancer? How is this determined?
  • Is lung cancer screening recommended for me?
  • What are the risks and benefits of lung cancer screening?
  • What are the next steps if the CT scan shows an abnormality?
  • If I’m concerned about managing the costs of my care, who can help me with these concerns?

More Information

Guide to Lung Cancer

Lung Cancer Screening

Understanding Cancer Risk

Quitting Smoking

Financial Considerations