Title : Is it fair calling LDCT lung cancer screening a failure? Why are less than 2% of those eligible getting screened?
Lung cancer is the leading cause of cancer death for both men and women worldwide, regardless of race and ethnicity. Each year, lung cancer alone claims the lives of more persons than all of the cancers of the breast, prostate, colorectum, kidney and melanoma combined. Historically, there has never been a widely accepted screening exam for the early detection of lung cancer that proved to reduce patient-specific mortality. This all changed however in November 2011 with the release of the National Lung Screening Trial (NLST) results which showed a 20% reduction in mortality in those high-risk persons that underwent annual lung screening with low-dose CT (LDCT). Subsequently, more than 40 medical societies and organization, many of which are stakeholders in lung health, lung disease, and lung cancer, have endorsed LDCT for the early detection of lung cancer in high-risk persons. The United States Preventive Services Task Force (USPSTF) in 2013 and the Centers for Medicare and Medicaid Services (CMS) in 2015 has also endorsed LDCT for the early detection of lung cancer in eligible persons. The latter endorsements allow at risk eligible persons to be screened without personal financial cost. Despite the cost of lung cancer screening with LDCT now being covered by CMS and most third party payer private insurance carriers, most high-risk former and or current cigarette smokers are still not taking advantage of early detection screening programs and remain at risk for this otherwise potentially lethal disease in the absence of proper screening. This presentation addresses some of the reasons why at risk persons are not seeking or being referred for lung cancer screening and potential ways to enhance screenee and provider participation.