Lung Cancer Screening Not So Simple, Report in AJMC Finds

Lung cancer screening is free under the Affordable Care Act for certain
current and former smokers, after a national study found their risk of
cancer death fell 20 percent through annual screening with low-dose
computed tomography (LDCT) instead of chest x-rays.

But getting the right people screened in the real world isn’t as simple
as it sounds, according to findings in the current
issue of The American Journal of Managed Care®.
Authors report on a demonstration project among current and former
smokers who were screened in the Minneapolis Veterans Affairs Health
Care System. Among their findings:

The research sheds light on the challenges of getting the large pool of
potentially eligible current and former smokers through the annual
screening process. Just 1.9 percent of eligible smokers were screened in
2016, according to data presented in
early June at the American Society of Clinical Oncology.

Criteria from the US Preventive Services Task Force call for screening
smokers age 55 to 80 who have smoked at least 30 pack-years, or those
with that history who have quit within the past 15 years. Thus, the
authors note, getting patients screened requires that health systems
have the capacity to capture patient information and track down those
who meet the criteria. Health systems also must handle patients who may
experience anxiety after a nodule is found, even if it is unlikely to
become cancerous.

“Important considerations in lung cancer screening are accurate
identification of eligible patients, balancing invitation approaches
with resource constraints, and establishing standardized methods for
tracking numerous small lung nodules and incidental findings detected by
LDCT,” the authors conclude.

“Lung cancer screening implementation presents unique challenges, but
they are not insurmountable. With more research and experience, we will
find the best method to deliver this important cancer screening
intervention to the millions of Americans that need it,” said Angela E.
Fabbrini, MPH, lead author and director of the lung cancer screen
program in the Minneapolis Veterans Administration Health Care System.

About The American Journal of Managed Care®:

The American Journal of Managed Care® (AJMC®)
is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the
forefront of health policy by publishing research relevant to industry
decision makers as they work to promote the efficient delivery of
high-quality care. AJMC.com is the essential website for managed care
professionals, distributing industry updates daily to leading
stakeholders. Other titles in the AJMC® family
include The American Journal of Accountable Care®,
and two evidence-based series, Evidence-Based Oncology™
and Evidence-Based Diabetes Management™. These
comprehensive offerings bring together stakeholder views from payers,
providers, policymakers and other industry leaders in managed care. To
order reprints of articles appearing in AJMC® publications,
please contact Jeff Prescott at 609-716-7777, ext. 331.

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