Medicare Plans to Pay for 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 plans to start paying for lung cancer screening for people at high risk, a move that advocates say could save thousands of lives every year by catching the disease earlier.

The Centers for Medicare & Medicaid Services (CMS) made a formal proposal Monday to start paying for low-dose CT scans to look for lung tumors for people with a high risk of the world’s No. 1 cancer killer.

“I think after a long effort to get to this point, CMS got it right,” said Laurie Fenton Ambrose, president and CEO of Lung Cancer Alliance.

“This has the potential of being one of the most significant cancer mortality-reducing efforts to date. We are finally focusing on what is a quarter of all cancer, and that’s lung cancer,” Ambrose told NBC News.

“We are going to see the meter move on cancer’s mortality. It’s an extraordinary time for our commuity and we are thrilled.”

“We are going to see the meter move on cancer’s mortality."

Many private insurers already pay for lung cancer screening.

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 future deaths from lung cancer, making it akin to mammograms and colonoscopies in terms of saving lives.

CMS would cover people ages 55-74 who have smoked at least a pack a day for 30 years, or the equivalent. The decision is now open for a 30-day comment period.

"We are confident that, while a draft, it should remain intact," Ambrose said.

Lung cancer is so deadly because it doesn’t start causing symptoms until it’s already spread. It kills nearly 160,000 people a year, according to the American Cancer Society. So the idea of screening people and catching the cancer early is appealing.

Using CT (computed tomography) screens for cancer isn’t cheap and it isn’t harmless. Spiral CT used to look for lung cancer is a low-dose form of X-ray, delivering about the same radiation as a mammogram. And CT scans aren’t always clear. A fuzzy blur on a CT scan might be a tumor, might be emphysema, an infection or even nothing, so people must get a second scan if there’s something suspicious looking there.

The National Lung Screening Trial showed that for every five to six lives saved by screening, one person died because of procedures done after screening, including surgery and biopsies that collapsed the lung.

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.

“We strongly advise older current and former heavy smokers to speak with their doctors about whether CT lung cancer screening is right for them."

"Medicare coverage provides access to care for seniors and will help physicians save thousands of lives each year from the nation’s leading cancer killer,” said Dr. Ella Kazerooni, chair of the American College of Radiology Lung Cancer Screening Committee.

“We strongly advise older current and former heavy smokers to speak with their doctors about whether CT lung cancer screening is right for them. If they and their doctor decide that screening is warranted, we encourage patients to seek out an ACR lung cancer screening center,” added Kazerooni.