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Heavy smokers get lifesaving advice

  • Article by: SABRINA TAVERNISE New York Times
  • July 29, 2013 - 8:33 PM

The U.S. Preventive Services Task Force on Monday recommended that heavy smokers get an annual CT scan to check for lung cancer, a major change in policy that experts say has the potential to save 20,000 lives a year.

Until recently, the medical consensus has been that there is too little evidence to justify lung cancer screening, largely because a chest X-ray — the usual screening technique — seldom catches the cancer early enough.

But that changed in 2010, when a large-scale clinical trial involving 53,000 patients that was conducted by the National Cancer Institute found that a CT scan, which detects much smaller tumors, could reduce mortality by 16 percent among patients at the highest risk of lung cancer. The findings provide the basis for the federal panel’s recommendation.

Lung cancer claims about 160,000 lives a year — more than a quarter of all cancer deaths and greater than the toll from colorectal, breast, pancreatic and prostate cancers combined. Nearly 90 percent of patients with lung cancer die from it, in part because it is discovered too late.

The recommendation, still in draft form, has the potential to change medical practice by making CT screening the standard of care for the highest-risk smokers.

And because insurers cover procedures strongly recommended by the preventive services task force, eligible patients would no longer have to bear the cost themselves. The procedure’s average price is about $170, according to Advisory Board Co., a health care research firm in Washington, which polled oncology professionals.

Medicare would also begin reimbursing for the scan. A Medicare spokesman said the agency would not immediately comment on how much the new screenings could cost.

The task force’s final recommendation will be issued three to six months after a public comment period, which ends Aug. 26, a spokeswoman said.

Dr. Harold Varmus, director of the National Cancer Institute, said the recommendation would “change the way people think about lung cancer.”

But he added that screening should not give smokers a false sense of security. “The main message is unchanged,” he said. “Don’t smoke.” Smoking is the culprit in about 85 percent of all lung cancer deaths.

Dr. Stephen Cassivi, a Mayo Clinic thoracic surgeon who was involved in the study, said Monday’s announcement marks “the first major federal body to recognize the benefit for patients in terms of saving lives of people with lung cancer.’’ But he noted that a complete cancer screening program involves more than just a CT scan; it also involves choosing the patients who are most at risk and developing “a structured plan when you find something.’’

Staff writer Dave Hage contributed to this report.

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