Cancer Control Video Series | Cancer Sites | Cancer Risk Factors | Improving Cancer Outcomes | Browse Resources

Benefits and Risks of low-dose CT screening for lung cancer

A new series of videos describing the benefits and risks of lung cancer screening is in development. In the meantime, below is a high level discussion of benefits, risks and risk reduction strategies.  The bottom line is that the benefit of 20% fewer deaths from screening far outweigh the risks in a structured, multi-disciplinary program.

The major benefit seen in high quality studies is:

  • 20% reduction in lung cancer mortality in a screened population vs an unscreened population after 3 sequential annual screens and 6-year follow-up without screening. (NLST study)
  • An 80% reduction in case fatality in those patients whose lung case was discovered at an early stage with continuous screening. (ELCAP study)

There are risks to lung cancer screening, as in any cancer screening. Many of them can be reduced in a structured, multi-disciplinary program that adheres to guidelines and protocols.

RisksRisk Reduction Strategies

Radiation risks

False positive screening results

Complications from invasive diagnostic procedures and surgery, including death.

Cost

Overdiagnosis

Anxiety

 

Use appropriate imaging equipment with low-dose settings and appropriate protocols

Engage radiologists trained in interpreting lung cancer screening CTs

Limit screening to high-risk patients in a well-managed, multi-disciplinary program

Carefully assess of risk malignancy in radiologic lesions prior to invasive procedures including:

  • Use of risk calculators
  • Review by multi-disciplinary panel
  • Interval follow-up with further CT according to guidelines
  • Use of least invasive diagnostic procedure when feasible

 

Videos

Watch a little at a time by clicking on the videos below or watch the entire video at the bottom of the page.

Part 1 - Overview (2:59)

Part 2 - NLST Trial (3:44)

Part 3 - CT Scans and Radiation (2:14)

Part 4 - Risks & Benefits of Screening (7:00)

Part 5 - Informed Decision Making (3:20)

Part 6 - Insurance Coverage for CT Screening 

Insurance Coverage for Low Dose CT Screening

A video with detailed information on insurance coverage for lung cancer screening is in development. In the meantime, the good news is that Medicare and commercial insurance plans pay for low dose CT screening in addition to a consultation for shared decision making with no co-payment for eligible patients.  The American Lung Association has more information about coverage and eligibility here

 

Addendum - CT Screening & Smoking Cessation (2:05)

 

Resources

Learning Objectives

  • Explain screening recommendations
  • Describe limitations of lung cancer screenings

Quiz and Certificate of Completion

Click Quiz and Certificate of Completion to take a short quiz and reeceive a certificate for this topic.

Presenters

Dr. Peter Bach MD, Memorial Sloan Kettering Cancer Center

Dr. Peter Bach is the Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering. Dr. Bach completed undergraduate studies at Harvard University and his Medical Degree from the University of Chicago Harris School. Dr. Bach’s research focuses on the cost and value of anticancer drugs. His work in lung cancer screening has lead to lung cancer screening guidelines and a risk-prediction model for disease.

Cancer Control Video Series | Cancer Sites | Cancer Risk Factors | Improving Cancer Outcomes | Browse Resources