Breath of Fresh Air: Medicare to Cover Lung Cancer Screening

Image: An x-ray image of a chest

This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer. NIH

Medicare said Thursday it will pay for lung cancer screening for people at the highest risk — a decision advocates say will save tens of thousands of lives.

It's been a controversial issue and some doctors question how many people will benefit from pricey, computed tomography scans to look for early evidence of lung cancer — by far the No. 1 cancer killer in the United States. But Medicare, the federal health insurance plan for people over 65, says the benefits are clear.

"This is the first time that Medicare has covered lung cancer screening. This is an important new Medicare preventive benefit since lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States," said Dr. Patrick Conway, chief medical officer for the Center for Medicare and Medicaid Services.

Medicare will pay for a once-a-year, low-dose CT exam for people aged 55-77 who are either current smokers or have quit smoking within the last 15 years; who have a tobacco-smoking history of at least 30 "pack years" (an average of one pack a day for 30 years); and who get a written order from a doctor.

"It will save tens of thousands of lives," says Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance.

"We think it's a transformative moment for our community."

Lung cancer kills so many people in no small part because it doesn't cause symptoms until it's too late. It kills nearly 160,000 people a year, according to the American Cancer Society.

The U.S. Preventive Services Task Force (USPSTF) recommends that heavy smokers who are at least 55 should have an annual CT scan to check for lung cancer. The recommendations could apply to about 9 million Americans.

Experts project that the screening test, which costs $250-$300, may prevent as many as 20 percent of deaths from lung cancer, making it akin to mammograms and colonoscopies in terms of saving lives.

A study published last May projected that paying for lung cancer screening would cost Medicare $9 billion over five years, or about $3 per month per beneficiary.

"This is a great day for those at high risk for lung cancer and their families. Now, we can save tens of thousands of people each year from this terrible disease that now kills more women in wealthy countries than breast cancer," said Dr. Douglas Wood, past president of The Society of Thoracic Surgeons.

One group that's left out: non-smokers. Ambrose says her group will press for inclusion of others at high risk of lung cancer such as people with occupational exposures to cancer-causing agents and people with a genetic risk.