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Kaiser: Experts question 'troubling' CT scan marketing

by Brendon Nafziger, DOTmed News Associate Editor | August 16, 2011
Some experts are raising their eyebrows over hospitals' offering cheap CT scans to smokers to check for lung cancer, with doctors warning the benefits of widespread screening - except possibly as a revenue generator - are unclear, according to Kaiser Health News.

The marketing push follows a groundbreaking national study announced last year that found screening current and former smokers with CT could help cut the death rate from lung cancer by 20 percent by finding tumors before they would be picked up by conventional chest X-rays.

However, the scans carry risks, such as a high false-positive rate that could lead to possibly unnecessary and costly biopsies and other invasive procedures. In the study, nearly a quarter of patients had a false positive exam. And the scans also expose the patient to radiation.
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Since the findings came out, doctors have been divided on the merits of instituting screening programs, even for high-risk populations like smokers. In part, the question is an economic one: the study suggests 300 high-risk patients need to be screened to prevent one lung cancer death over a five-year period, Kaiser said.

Still, according to Kaiser, hospitals have been found offering the scans for rates as low as $49, when the typical cost of a lung scan is anywhere from $300 to $1,000.

The discount comes as the costs of the scans must be borne out-of-pocket by consumers. Medicare and private payers don't pay for the screening tests, at least not yet. The bean-counters at the Centers for Medicare and Medicaid Services, it seems, are waiting for a federally-funded cost-benefit analysis to wrap up before they make up their mind, according to the Washington Post.

Lung cancer is the leading cause of cancer-related deaths in the United States, killing 157,000 Americans a year, according to the National Cancer Institute. Usually, by the time symptoms appear (such as shortness of breath), it's often too late.

It's also the second-most common cancer, with more than 222,000 new cases diagnosed every year. Treatment costs are estimated at $10 billion annually.

That's partly why the National Lung Screening Trial, which concluded early last year because of promising results, was so widely embraced: it suggests a way to change those grim statistics.

In the decade-long study, which involved more than 53,000 patients, the researchers compared current and former smokers who underwent three yearly screenings, either with low-dose helical CT scans, or standard chest X-rays. By the end of October 2010, when the study wrapped up, there were 354 deaths from lung cancer in the CT group, but 442 deaths in the X-ray group, a 20.3 percent reduction.

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