Task force recommends annual CTs for smokers

Insurers, Medicare to begin offering no-cost screenings

Current and former smokers ages 55 to 79 should receive annual CT scans for lung cancer, which could save about 20,000 lives annually, according to a draft recommendation released Monday by the U.S. Preventive Services Task Force (USPSTF).

>> Also see: Lindsay Conway explains the implications of USPSTF's recommendation

According to the New York Times, about 90% of patients who are annually diagnosed with lung cancer— or about 160,000 individuals—die from the disease, accounting for more than 25% of all cancer deaths annually. An estimated 37% of U.S. adults are current or former smokers, observers say.

Under the draft recommendation, which also appeared Tuesday in the Annals of Internal Medicine, health care providers are urged to offer a low-dose CT scan to individuals between ages 55 and 79 who would be considered "heavy" or high-risk smokers. Such individuals have smoked at least a pack per day for at least 30 years, or two packs per day for 15 years.

The recommendation was assigned a "B" rating, which means insurers would have to cover the CT scans as a preventive service at no cost to patients under the Affordable Care Act.

Basis for recommendations

The panel based its recommendation on results from a landmark National Cancer Institute study which found that smokers who underwent CT scans had a 20% lower risk of dying from lung cancer compared with patients who underwent chest X-rays. The panel acknowledged that although the CT screenings would avert more than 500 lung cancer deaths, they could cause the deaths of about 24 per 100,000 smokers as a result of radiation exposure.

USPSTF co-Chair Michael LeFevre said providers would need to use cost-benefit analyses to determine whether individual patients should undergo the procedure. Further, primary care physicians would be responsible for deciding whether their patients would benefit from such screenings. Nonetheless, "We believe the benefits do outweigh the harms," LeFevre concluded.

The draft recommendation is open for public comment until Aug. 26 (Bernstein, Washington Post, 7/29; Burton, Wall Street Journal, 7/29; Tavernise, New York Times, 7/29).

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