Implementing computed tomography-based lung cancer screening in the community

CT-based lung cancer screening was recommended as a proven cancer early lung cancer detection test after extensive evaluation and the finding of a 20% mortality reduction in the National Cancer Institute sponsored, National Lung Screening Trial (NLST). That study took just under ten years and a quarter of a billion dollars to complete but it conclusively addressed the critical question of whether CT screening could really save lives. Now under provisions of the Affordable Care Act, private insurance companies and federal insurance programs [Center for Medicare and Medicaid Services (CMS)] are reimbursing for CT-based lung cancer screening without deductibles, co-sharing or co-payments to ensure broad access to this new service. This cancer screening service is now being rolled out responsibly in community settings across the country. In the dialogue about providing this service there was considerable discussion about potential harms that could occur with providing this service. For this reason, the recent article from Miller et al. is important new information that outlines a robustly positive preliminary lung cancer screening experience at one community hospital system (1). Given the extent of interest in this new service; it is worth taking a closer look at their experience.