We at the Lung Disease Center were the first to develop a lung cancer early detection program in our community. The program, as I am sure you know, was based on a large study of smokers at risk for lung cancer. We actually had some of our patients enroll in the trial, and some actually had cancers found and were treated and survived. Because the screening involves the use of an annual CT scan of the chest, which is costly, insurance providers have been very strict about the criteria we, as pulmonary physicians, can use to enroll patients in an early detection program. Insurers looked at the original data, which was based on a population of patients 55-75 years of age and who smoked at least 30 pack years (a pack year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years smoked). This strict interpretation of the study has presented some problems. We often have patients who have smoked 30 or more pack years before age 55. We also have patients at high risk older than 75 years of age.
New recommendations are being put forth that will allow screening of individuals to age 77 and also allow more flexibility if some patients do not meet the 30 pack year rule but are at high risk for other reasons, such as asbestosis or radiation exposure. No word from insurers, including Medicare, yet, but stay tuned.