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Lung CT scans cost-effective group at high risk of cancer, study finds

Monday, April 9, 2012 4:37 PM
Last updated Tuesday, April 10, 2012 2:23 AM
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Sharon Bodkins made her husband stop in his tracks when she was handed the results of a lung CT scan at Doctors Hospital.

Dr. Carmel Joseph, left, and Dr. Phillip Catalano stand in front of a CT Scanner at Doctors Hospital in Augusta. Doctors Hospital has been pushing for a relatively low-cost CT scan for smokers as a way to detect lung cancer early.   Emily Rose Bennett/Staff
Emily Rose Bennett/Staff
Dr. Carmel Joseph, left, and Dr. Phillip Catalano stand in front of a CT Scanner at Doctors Hospital in Augusta. Doctors Hospital has been pushing for a relatively low-cost CT scan for smokers as a way to detect lung cancer early.

“I was overwhelmed with happiness that they didn’t see any cancer,” said Bodkins, 66, of Appling, who has smoked for 30 years.

“Absolutely, it was worth it,” she said, even though she had to pay the $270 herself.

A new study out Monday in the journal Health Affairs argues that in patients such as Bodkins, it would be cost-effective for insurance to cover annual lung CT scans.

The study looked at people ages 50-64 who have smoked a pack a day for at least 30 years, who would be considered at higher risk of lung cancer. The study estimated that is 18 million people in the U.S. Even if only half of them took advantage of low-dose CT scans of the chest each year, it would cost insurance companies about 76 cents per covered member each year, the study found.

In a similar population, the National Lung Screening Trial found that getting an annual screen reduced cancer-related deaths by 20 percent. The authors of the current study said such an annual screening program would cost about $18,800 per year of life saved, which compares well with other cancer screenings, such as mammography, which is $31,000 to $51,000 per year of life saved.

Lung cancer kills about 150,000 people a year in the U.S., which is more than breast, colon, prostate and cervical cancers combined, according to the study.

Thoracic surgeon Philip Catalano helped push Doctors Hospital to offer the low-cost screening to high-risk patients because their outcomes are much better if lung cancer is caught early.

“Unfortunately, once they start having symptoms, a lot of times you can’t make the procedure so that it takes care of this problem forever,” Catalano said. Once it gets beyond stage I or stage II, the chance of cure is much less, pulmonologist Carmel Joseph said. Low-dose CT scans offer much less radiation than previous methods such as chest X-rays, which can miss 15 percent to 20 percent of cancers, he said.

“For screening use, it’s a better tool,” Joseph said.

Cancers caught in earlier stages could allow treatment robotically, which Catalano is one of the few to use in the chest — a minimally invasive procedure — versus the standard incision that goes down the back and up the side and can result in lingering pain.

Studies like the one out Monday should help convince insurance companies annual screenings would be worth it in the high-risk group, Catalano said.

“With this kind of data, more people will be apt to cover it for two reasons,” he said. “The money aspect is less, and the results are so much better.”


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