From the September 2017 issue of HealthCare Business News magazine


Low-dose CT lung cancer screening
The National Lung Screening Trial, which was published in the New England Journal of Medicine in 2011, was the first to shine a light on the value of low-dose CT lung cancer screening.

The trial included 53,000 healthy older adults with a history of heavy smoking who were cared for at 33 different facilities. Half were screened with LDCT and the other half with X-ray and the results demonstrated that LDCT lowered the morality rate by 20 percent.
Members of Congress as well as a number of organizations joined forces in 2014 to push for Medicare coverage of LDCT lung cancer screening.

The moment the industry was waiting for came on Feb. 5, 2015, when Medicare issued its final decision on LDCT lung cancer screening. The agency decided that there was sufficient evidence to cover screening for individuals considered to be at high risk.

Those individuals are between the ages of 55 and 77 with no current signs or symptoms of lung cancer. They must have a smoking history of at least 30 pack-years or be current or former smokers who quit within the last 15 years.


GE was the first to get the FDA nod for LDCT lung cancer screening in August 2015. The screening protocol can be implemented on any of its 64-slice or greater CT scanners and most of its 16-slice systems.

In November 2015, the FDA cleared Siemens' SOMATOM CT systems for LDCT lung cancer screening, which includes the 16-slice SOMATOM Scope and ultra-premium SOMATOM Force.

In April 2016, Philips CT and PET/CT models were approved by the FDA for LDCT lung cancer screening. All 27 models can also be used for dose management and image data sharing and analytics through the Philips IntelliSpace Portal.

Despite the initial hype, the adoption of LDCT lung cancer screening has been relatively slow. According to Ken Denison, molecular imaging and CT dose leader at GE, that's due to the challenges associated with getting CMS reimbursement.

"They have to prove they had a smoking cessation conversation and risk-benefit conversation with the patient," he adds. "That whole process is pretty challenging to implement from scratch."

In addition, general practitioners have mixed views on its value. Given that they're the ones that primarily drive the conversation to recruit smokers and former smokers into a program, that presents a challenge as well.

There is also reluctance expressed by patients. Denison explains that if patients don't feel like they have a problem, they don't see the point in getting screened.

September 2017 Magazine

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