CHICAGO, IL—Implementing the U.S. Preventive Services Task Force (USPSTF) recommendation for annual low-dose computed tomography (LDCT) lung cancer screening among high-risk smokers will more than double the proportion of early-stage lung cancer diagnoses among Medicare beneficiaries, according to a model that will be presented at the 2014 American Society of Clinical Oncology Annual Meeting on June 2nd.
Increased screening would result in the identification of 101,000 to 141,000 additional lung cancers, mostly stage I, according to lead author Joshua Roth, PhD, MHA, a postdoctoral research fellow at Fred Hutchinson Cancer Research Center in Seattle, WA.
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That would cost up to $27 billion in additional Medicare expenditures, including costs of diagnostic work-ups and interventions following LDCT, if screening is fully implemented, he estimated.
“Our analyses suggest that LDCT screening will increase lung cancer diagnoses, result in a greater proportion of cases diagnosed at an early stage, and substantially increase Medicare expenditure,” he said.
The USPSTF recommends annual LDCT screening for patients between the ages of 55 and 80 years with a 30 pack-year smoking history, who currently smoke, or who quit in the past 15 years.
However, those costs could be “offset to some extent” by savings associated with early-stage diagnosis, he acknowledged.
Medicare’s coverage of LDCT will be decided and announced later this year, he said. If screening recommendations are implemented among Medicare beneficiaries, however, health care systems will have to build screening infrastructure and personnel, so implementation will be gradual, Roth noted.
“Medicare and contracted health care systems should plan for increased demand for LDCT imaging and associated health professionals … and increased expenditure, particularly for LDCT screening tests,” Roth said during a pre-conference presscast.
ASCO’s guidelines support the USPSTF recommendations, noted ASCO President Clifford Hudis, MD, FACP.
“This is a model, not actual data,” he cautioned.
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Tobacco use continues to drive “far too much of the nation’s cancer burden,” Dr. Hudis added. LDCT screening offers “a long-awaited early lung cancer detection strategy,” but physicians “must do everything possible to provide patients with the encouragement and resources they need to stop smoking, and prevent the next generation of young adults from starting.”
Pack-years are calculated by multiplying the number of packs of cigarettes a patient smokes per day by the number of years the individual has smoked.
- Roth JA, Sullivan SD, Ravelo A, et al. Abstract 6501. Presented at: American Society of Clinical Oncology Annual Meeting 2014; May 30-June 3, 2014; Chicago, IL.