Implementation of an annual low dose CT (LDCT) lung cancer screening program for Medicare recipients who are at the highest risk for disease would detect at least 54,900 additional cancers and cost Medicare $9.3 billion over five years, new research shows.
For the study, to be presented next week at the annual meeting of the American Society of Clinical Oncology, Joshua Roth, Ph.D., a postdoctoral research fellow at research fellow at the Fred Hutchinson Cancer Research Center and colleagues developed a study model based on the United States Preventive Services Task Force recommendations for CT lung cancer screening--annual low-dose CT scans for current and former smokers aged 55 to 79 with at least a 30 pack-year history of smoking who had their last cigarette sometime within the last 15 years.
"We predicted that over a 5-year period, LDCT would result in more lung cancers, a shift toward an earlier stage of diagnosis, and increased expenditure, particularly on scans themselves," Roth told Medscape Medical News. "With that in mind, if screening is covered, it is important for Medicare and contracted healthcare systems to plan for an increased demand for LDCT imaging and treatment capacity for a growing early-stage lung cancer population."
In what the researchers determined would be the most likely use screening scenario (in which half of patients offered screening would undergo the test), adding CT lung screening coverage to Medicare would result in $5.6 billion in expenditures on imaging, $1.1 billion on diagnostic workups, and $2.6 billion on cancer care expenditures during the next five years. This would represent about a $3 monthly premium increase per Medicare recipient.
The researchers also determined the program would yield 11.2 million more LDCT scans and double the proportion of early stage diagnoses from 15 percent to 33 percent.
Of course, Medicare currently doesn't cover CT lung cancer screening and the chances of that changing in the future were dealt a blow recently when the Medicare Evidence Development and Coverage Advisory Committee voted against recommending Medicare coverage for annual CT lung cancer screening.
Harvey Pass, chief of thoracic oncology at the Perlmutter Cancer Center of NYU Langone Medical Center in New York, told HealthDay News that the study supports the argument that Medicare should cover lung cancer screening. He was not involved with the study.
"In the United States, prices for a carton of cigarettes can vary from $30 to $70 for a brand name," Pass said. "For the cost of one carton of cigarettes, an individual would be able to afford the monthly premium, according to this study, for Medicare to cover the added expense of lung cancer screening."