Annual CT lung scans urged for heavy smokers

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WASHINGTON -- 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 said had 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 for lifesaving surgery.

But that changed in 2010, when a large-scale clinical trial involving 53,000 patients, 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 panel's recommendation Monday.

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 make 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.

National Cancer Institute director Harold Varmus 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.

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