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Study projects doubling of the proportion diagnosed with early-stage lung cancer if Medicare implements recommended LDCT screening - Fred Hutchinson Cancer Research Center

SEATTLE – May 14, 2014 – Recommendations by the U.S. Preventive Services Task Force suggest annual low dose computed tomography (LDCT) screening for lung cancer in high-risk patients. A new study projects that implementing this screening policy in the Medicare program could result in approximately 54,900 more lung cancer cases detected over a five-year period, a majority of which would be early-stage disease. The study is the first to look at a lung cancer screening model specifically focused on the Medicare population, which has the highest lung cancer incidence and a large proportion of members that qualify for screening.

The new screening model projects an estimated increase in the proportion of early-stage diagnoses from 15 percent to 33 percent over five years.

“Lung cancer is the leading cause of cancer death in the United States. That’s mainly because lung cancers often aren’t caught until they are at an advanced stage,” said lead study author Joshua Roth, Ph.D., MHA, Hutchinson Institute for Cancer Outcomes Research. “If we can periodically look for and detect cancer earlier that allows for potentially curative surgery, and generally, a much better survival prognosis.”

The USPSTF recommends annual LDCT screening in healthy people aged 55 to 80 who have a 30 pack-year smoking history who currently smoke or have quit in the past 15 years. The recommendations are largely based on findings from the National Lung Cancer Screening Trial, which demonstrate a 20 percent reduction of lung cancer deaths with LDCT screening compared to X-ray screening.

The model assumes that, over a five-year period, an additional 20 percent of high-risk patients are offered screening each year. Implementing the new guidelines could result in a cost increase of $9.3 billion over the next five years with approximately $5.6 billion more spent on low-dose CT imaging, $1.1 billion for diagnostic workups, and $2.6 billion more in cancer care expenditures. This total five-year Medicare expenditure amounts to a $3.00 per-month premium increase per Medicare member.

Researchers are planning future analyses that will assess and consider available resources and demand for additional scanners and technologists. These analyses will help healthcare systems adequately prepare for the implementation of the USPSTF screening policy, if Medicare decides to cover screening. A draft decision on Medicare coverage will be posted in November.

“The key to the success of this screening program is ensuring that those who are at high risk actually undergo screening and subsequently receive appropriate treatment,” Roth added.


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