Medicare and Medicaid now cover low-dose CT screening for lung cancer at no cost to patients
To be eligible for this annual coverage benefit, a patient must be between the ages of 55 and 77, a smoker or former smoker who has quit smoking within the last 15 years, and have a significant smoking history (i.e., at least 30 pack-years, where one pack-year is the equivalent of smoking one pack per day for one year). Patients also must have a written order from their physician.
In South Carolina, at least 15 hospitals and radiology centers provide low-dose CT screening for lung cancer, and this list continues to grow. You can search for these facilities on the Lung Cancer Alliance website or using the American College of Radiology-Accredited Facility Search Tool. Eligible veterans who have access to VA care also can receive the screening, either at the patient’s usual VA facility or by referral to a non-VA care provider in the community, depending on local policies.
The goal of the screening is to detect cancer at the early stages, when it is most treatable and most curable. This type of screening has a unique set of benefits — and potential harms — that patients should be aware of. Although the greatest benefit is a reduced chance of dying from lung cancer (a 20 percent mortality reduction in those screened with low-dose CT has been reported), risks include the possibility of undergoing unnecessary procedures to follow up an abnormal result that is later found to be benign. Screening is not for everyone, and patients need to be informed about these benefits and potential harms.
Research shows that many primary-care physicians are still unaware that Medicare and Medicaid will reimburse for lung cancer screening. Many physicians also do not realize that medical experts such as the U.S. Preventive Services Task Force recommend low-dose CT screening for lung cancer in all persons who meet the eligibility criteria described above.
Be an informed patient, and take the lead in initiating a conversation with your doctor about lung cancer screening and whether it is right for you.
Jan M. Eberth
Cancer Prevention and Control Program
University of South Carolina