To Screen Smokers for Lung Cancer or Not: Doctors Unsure

While Medicare is ready to pay for an annual spiral CT scan for long-term smokers, some doctors think it's an unnecessary procedure that might do more harm than good.

In February, Medicare announced that it would pay for an annual lung cancer screening test for certain long-term smokers. Medicare recipients between the ages of 55 and 77 years who have smoked the equivalent of a pack a day for 30 years are now eligible for the annual test, known as a spiral CT scan.

Medicare's decision was partly a response to a 2011 study showing that screenings with the technique could reduce lung cancer deaths by 20%. Some images of lung cancer are clear cut. But in many others, a nodule on the screen turns out not to be cancer at all.

That translates into thousands of lives each year, says Dr Claudia Henschke, a radiologist who heads the lung and cancer screening program at New York's Mount Sinai Medical Center. "It's a tremendous step forward," she says, primarily because lung cancer is such a big killer. The disease claims more than 150,000 lives in the U.S. each year, more than the next three cancers — breast, prostate and colon cancers — combined.

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