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Hospitals Hype Bargain Lung CT For Smokers

August 17, 2011
Written by: , Filed in: Chest Radiology, Medical Ethics, Practice Management
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A big new screening regime may be getting under way as hospitals start offering bargain lung CT scans for smokers.

Last November, the National Cancer Institute halted the National Lung Screening Trial early because results dramatically showed that low-dose helical CT was much better than a standard chest X-ray at screening for lung cancer among smokers.

The study, published online earlier this year in The New England Journal of Medicine, found a 20 percent decrease in deaths among those screened with CT compared to those screened with standard X-rays.

As a result, according to a Kaiser Health News report by Phil Galewitz, hospitals are offering the lung CT scan, which takes only 10 seconds but normally costs up to $1,000, for as little as $49.

That’s great, right? Neither Medicare nor private insurers cover the test, so the low cost will help catch more cancers in early, treatable stages. William R. Burfeind Jr., MD, is a cardiothoracic surgeon at St. Luke’s Hospital & Health Network of Bethlehem, Pennsylvania. St. Luke’s has distributed a flyer with a $49 coupon for the screening. Dr. Burfeind told Kaiser Health News:

The vast majority of my patients show up with stage 3 or 4, which is treatable but rarely curable. Once we learned the results of the national study, we felt compelled to offer this to our patients.

Yes, but …

H. Gilbert Welch, MD, a researcher at Dartmouth Medical School in Hanover, New Hampshire, who studies cancer screening, said:

You have to ask the question, ‘Whose interests are being served here?’ Screening tests are a great way to recruit new patients that produce revenues with follow-up biopsies and procedures.

Dr. Welch and others worry about the downsides. In the national study, nearly a quarter of the subjects had a false positive, which can lead to unneeded, expensive, and risky biopsies or other invasive procedures. And nobody knows the long-term risks of the radiation exposure, especially for tissue that is already at risk because of exposure to tobacco smoke.

In fact, another study backed CT as a lung cancer screening tool for high-risk populations only if it were done with a strict clinical protocol in place and input from a multidisciplinary care team—precisely to avoid false positives. One wonders whether hospitals will do all that for $49.

So here’s the question about lung CT screening for smokers: Is it a public health benefit or a profit generator?

Or both?

And if both, is there a problem with that?

* * *

Here’s a bigger bargain than a $49 CT scan: our Facebook page—always free.

Related seminar: Thoracic Imaging

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One Response to “Hospitals Hype Bargain Lung CT For Smokers”

  1. Radiology Daily»AlertArchive » CT Lung Screening? Annals Says: Yes And No on September 7th, 2011 at 10:06 am

    […] of Internal Medicine this week presented both sides of what has become a vigorous debate—and a potential economic opportunity—ever since the preliminary results of the National Lung Screening Trial were released last […]