Physician ignorance of lung cancer screening guidelines, lack of patient and physician education on the benefits of screening and drastically low Medicare reimbursement for low-dose computed tomography (LDCT) lung cancer screening exams may be resulting in thousands of unnecessary deaths each year.

More than 220,000 people will be diagnosed with lung cancer in 2018. Nearly 160,000 people will die from the disease — more than from breast, colon and prostate cancers combined. This exam is the first and only cost-effective test proven to significantly reduce lung cancer deaths.

The United States Preventive Services Task Force (USPSTF) recommends lung cancer screening for high-risk, older current and former smokers. Yet, these exams remain comparatively unused – according to a recent study presented at the American Society of Clinical Oncology (ASCO). All the while, people are dying.
“CT lung cancer screening can save more lives than any cancer screening test in history, but patients are not hearing about this test from their doctors. Medicare is not adequately covering these exams. This noncompliance and practical non-coverage is contributing to unnecessary deaths due to lack of screening,” said Ella Kazerooni, MD, FACR, chair of the American College of Radiology Lung Cancer Screening Committee and ACR Thoracic Imaging Panel.

False Positives Overstated

Updates to Lung-RADS™ - a quality assurance tool to standardize lung cancer screening CT reporting and management recommendations – has reduced false positive rates by 75 percent compared to previous studies. This process will improve, but only with an adequate number of patients to screen and review.

Previous psychological studies show that patient concern over cancer screening false positives is short-term with no lasting effects.

Given the immediate threat to older current and former smokers from this disease, the significant lifesaving benefit of these exams outweighs any likely harms to the defined screening population. In fact, patients are required by law to be made aware of the harms of screening and other pertinent information prior to any exams being performed.

Physicians Not Adhering to Guidelines

Unlike breast and colon cancer screening, a patient’s primary care physician must approve the patient to get a lung cancer screening exam during a shared-decision making visit. Many of these providers are unaware of the exams – or not informed on the benefits of these scans.

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