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Lung Cancer Screening Now Covered by Medicare

by Dr. Sharon Orrange on February 19, 2015 at 11:31 am

In the United States, lung cancer is the leading cause of death from cancer. The American Cancer Society estimates that 28% of all deaths from cancer in the U.S. are from lung cancer. The average 5-year lung cancer survival is among the poorest of all cancers (17%) because sadly the majority of patients are diagnosed with advanced disease.

Well, can I be screened for lung cancer? Yes, and as of this month Medicare coverage will be provided for screening for lung cancer with low dose computed tomography (LDCT). This is the first time that Medicare has covered lung cancer screening. Finally, there is an opportunity to reduce deaths from lung cancer in a high-risk group of current and former smokers.

Who should be screened for lung cancer?

You should be screened if:

  • You are 55 years to 77 years old and are either a current smoker or have quit smoking within the last 15 years.
  • You have at least a 30–pack-year (1 pack per day for 30 years or 2 packs per day for 15 years) smoking history.
  • You must also have a written order from a physician for the test.

How do we screen for lung cancer?

  • You will get a low-dose radiation chest CT scan (LDCT) which has been shown to substantially reduce the risk of dying from lung cancer.
  • Adults who choose to be screened should receive once a year LDCT screening until they reach age 74 years (77 per some guidelines).
  • Remember, chest x-ray is not to be used for lung cancer screening.

What are the downsides of LDCT for screening?

  • LDCT will not detect all lung cancers or all lung cancers early, and not all patients who have a lung cancer detected by LDCT will avoid death from lung cancer.
  • There is a significant chance of a false-positive result, which means you may require additional testing and, in some instances, an invasive biopsy to determine whether or not an abnormality is lung cancer.
  • For patients who are at lower risk screening is not recommended. For these lower-risk patients, the harms outweigh the benefits.

If you’ve had an LDCT for screening, let us know how it went.

Dr. O

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