Other Considerations for LDCT Screening
Costs
- LDCT screening costs are often covered by insurance, but abnormal results may lead to costly surveillance and diagnostic tests and treatment.
- The Affordable Care Act mandates coverage for screening, but additional follow-up assessments and treatments may not be fully covered, and patients may face out-of-pocket costs.4
Radiation
- Radiation exposure over time can cause cancer and even lead to cancer deaths.
- Approximately 1 cancer death may be caused eventually (after 10–20 years) from radiation per 2500 persons screened.5
Radiation Comparison6
| LDCT | Diagnostic CT | Annual Background | Chest X-Ray |
Mammogram |
|---|---|---|---|---|
| 1.5mSv | 7mSv | 3-5mSv | 0.1mSv | 0.4mSv |
Availability
- LDCT is available in most major hospitals, but may not be accessible in rural areas.
- Offer screening only if eligible patients can access appropriate screening and treatment facilities.7
False Sense of Well-Being
- Negative results may give patients a sense of well-being, and discourage tobacco cessation. Providers should offer cessation counseling to all smokers.8
Refences:
4. US Department of Health and Human Services. Key Features of the Affordable Care Act. Washington, DC: US Department of Health and Human Services. Available at: http://www.hhs.gov/healthcare/facts/timeline/index.html. Last accessed: July 31, 2015.
5. Bach PB, Mirkin JN, Oliver TK, Azzoli CG, Berry DA, Brawley OW, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA. 2012 Jun 13;307(22):2418-29. doi: 10.1001/jama.2012.5521. PMID: 22610500
6. RadiologyInfo.org. Radiation Dose in X-Ray and CT Exams. Radiological Society of North America, Inc. http://www.radiologyinfo.org/en/info.cfm?pg=safety-xray. Last accessed: March 2, 2016.
7. Wender R, Fontham ET, Barrera E, Jr., Colditz GA, Church TR, Ettinger DS, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013;63(2):107-17.
8. Zeliadt SB, Heffner JL, Sayre G, Klein DE, Simons C, Williams J, et al. Attitudes and Perceptions About Smoking Cessation in the Context of Lung Cancer Screening. JAMA Intern Med. 2015 Sep;175(9):1530-7. doi: 10.1001/jamainternmed.2015.3558.