A non-invasive process that makes 3D pictures of the lungs could reduce lung cancer deaths by 35 percent for relatively low cost per life saved.
In a newly released large scale study, results of an actuarial analysis showed that providing spiral CT screening as a commercial insurance benefit in the high-risk US population would cost about $1 per insured member per month in 2012 dollars, and could save approximately 130,000 lives annually.
The study by a team of actuaries from the consulting firm Millman and cancer expert James Mulshine, of the Rush University Medical Center, in Chicago IL, was published in the April 13 issue of Health Affairs. There are 18 million people at high risk for lung cancer in the U.S. - most are current and former heavy smokers (a pack a day for 30 years) between ages 50 and 64. The per-life savings worked out to $19,000 to $25,000, right in line with other preventive screenings like colonoscopies, and was more cost effective than Pap smears and or mammograms.
Study authors recommended that insurance companies and Medicare cover CT scans for high-risk patients. According to National Public Radio, Wellpoint is believed to be the only insurer that currently does so. The American Cancer Society estimates that 226,160 new cases of lung cancer (both small cell and non-small cell) are diagnosed in the United States each year and about 160,000 people die from the disease annually (2012 figures). If the cost of these scans was covered by health insurance, earlier detection would result in the majority of those people surviving.
Where the screenings are conducted affect the total cost-savings, said Harry Raftopoulos, MD, Associate Professor of Medicine, Hofstra North Shore-LIJ School of Medicine and Associate Attending Physician, Monter Cancer Center, North Shore-LIJ Health System in New York. He cautioned that while the analysis and data are solid, "the assumptions on which many calculations were based came from rigorous screening studies, conducted at high quality institutions with multidisciplinary thoracic oncology teams in place. It is unknown whether the same cost-efficacy would be demonstrated if screenings were being conducted by stand-alone facilities without multidisciplinary backing."
However, if done under the appropriate parameters, he completely agrees with the authors' conclusions. "CT screening for lung cancer should be covered by insurance for high risk individuals at high quality institutions with the expertise to ensure appropriate -- and not excessive -- follow-up."