CT Lung Cancer Screening

CT Lung Cancer Screening

In June 2011, the New England Journal of Medicine published results from the landmark National Lung Screening Trial (NLST) that showed a 20% mortality reduction in a high-risk population who had undergone low-dose CT. NLST is the first lung cancer screening trial to demonstrate such a mortality benefit for the most lethal cancer in America today. Learn more about lung cancer.

Following this, the National Comprehensive Cancer Network (NCCN) issued guidelines recommending low-dose CT screening for lung cancer, and the United States Preventive Services Task Force (USPSTF) issued their recommendation for annual low-dose CT screening in high-risk individuals at the end of 2013.

Stanford Health Care believes strongly in innovative solutions for preventive care. Therefore, our Imaging Department will be offering this screening test to patients who meet the criteria recommended in either the USPSTF or NCCN guidelines (See Exam Eligibility).

Eligible patients must be referred by a doctor and active smokers undergoing screening CT should enter a smoking cessation program. We re-iterate that screening is not an alternative to smoking cessation which is the most important action that can be taken by current smokers to minimize their likelihood of developing cancer. Visit our Smoking Cessation Program to join or learn more.

False positives

Over the period that NLST participants were screened, approximately 40% of individuals had a positive CT result, usually consisting of small indeterminate pulmonary nodules considered suspicious for lung cancer, on at least one of the three annual tests. Of these initial findings, 96% were false positives, but required diagnostic follow-up, mostly with further imaging, and in some cases involving invasive procedures such as bronchoscopy, biopsy or surgery. The death rate from any cause in the CT screening group was reduced by 6.7%, compared to the radiography group. One death from lung cancer was prevented per 320 participants in screening.

Radiation dose reduction and optimization

At Stanford Health Care, we understand that radiation exposure is a concern to referring physicians and patients. We are committed to reducing radiation exposure and following radiation safety principles. CT lung cancer screening will be a low-dose CT exam, with a radiation dose equivalent to approximately half of the naturally occurring background radiation that a person receives for one year at sea level. Ths exam does not require intravenous contrast.

Insurance Coverage

CT Lung Cancer Screening (CPT S8032 )

Private Insurance and Covered California

Under the Affordable Care Act, effective prevention measures—graded A or B—are included in the Essential Health Benefit. Patients who meet the screening criteria will have insurance coverage for screening without co-payments or other barriers starting January 1, 2015. See U.S. Preventive Services Task Force Recommends Screening for those at High Risk of Lung Cancer to learn more.

Centers for Medicare & Medicaid Services (CMS)

CMS is following the USPSTF guidelines, except the age is 55-77 versus 55-80.

• CMS covered effective February 5, 2015
  
• USPSTF Eligibility Guidelines
• CMS age eligibility is age 55-77 years

Read about CMS's decision on CT lung cancer screening approval (PDF).

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