The Lung Disease Center of Central Pennsylvania was the first in the area to adopt the findings from the National Lung Screening Trial. This study demonstrated that screening high-risk smokers (or former smokers) with low dose chest CT scans could reduce lung cancer mortality by 20% compared to simple chest x-rays. The US Preventive Services Task Force recommended using this type of screening in 2013. It was during this time that many insurance carriers, including Medicare, refused to pay for this service because it was a “screening” procedure not a diagnostic one. It was not until 2015 that Medicare agreed to provide payment for this screening and private carriers followed suit.
Different groups have offered criteria for screening patients. The original trial studied patients that were former or current smokers for at least 30 pack years (smoking one pack of cigarettes per day = one pack year). The age range was 55 to 74 in the original study, but some groups have advocated screening up to age 77 or 80.
A recent review of this now-accepted screening procedure looked at the cost-effectiveness of screenings. Specifically, along with improvement in mortality, did the screening actually save more money than was spent? CT scans are much more expensive studies than the usual chest x-ray so despite the improvement in mortality was it really worth spending the money on screening.
We are all happy to know that the analysis shows that CT scan screening for at risk patients is clearly cost-effective.