Annual Screening for Lung Cancer Is Cost-Effective, Study Finds

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Annual CT scans for lung cancer in longtime tobacco users could save thousands of lives per year and cost less than common screening practices for other cancers, according to a study published in the journal Health Affairs, NPR's "Shots" reports (Knox, "Shots," NPR, 4/10).

For the study, researchers examined published data on the effect of screenings on smokers and long-term former smokers between ages 50 and 64.

They estimated that 18 million U.S. residents are current or former heavy smokers within that age range and that about half those individuals would receive annual lung cancer screenings if they were covered by their insurance plans. Because of limited data on its cost effectiveness, most insurers do not cover lung cancer screening, even for high-risk patients, according to MedPage Today.

The researchers determined that the screenings would cost $247 per screened patient annually. Total costs would amount to $0.76 per insured individual monthly with no cost sharing, less than the cost of breast, colorectal and cervical cancer screenings.

The researchers also found that the procedure could lead to an additional 130,000 lung cancer survivors in 2012. As such, they determined that the cost per life-year saved would be $19,000. In comparison, breast and cervical cancer screenings cost $31,000 and $50,000 per life-year saved, respectively (Fiore, MedPage Today, 4/10).

The study confirms findings published last year by the National Cancer Institute and builds pressure on insurers to cover the screenings for lung cancer, the most lethal cancer in the U.S. (Pecquet, "Healthwatch," The Hill, 4/10). The researchers urged commercial insurance companies to "consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least 50-years-old and have a smoking history of thirty pack-years or more" (MedPage Today, 4/10).

Researchers Find Higher Spending on U.S. Cancer Care Is 'Worth It,' Critics Note Study Flaw

In related news, U.S. residents who were diagnosed with cancer between 1995 and 1999 had an average survival rate of 11.1 years, compared with 9.3 years for individuals living in 10 European countries who were diagnosed with cancer during the same timeframe, according to a study published on Monday in the journal Health Affairs, Reuters reports.

The study attributed the longer survival rate to higher spending on health care in the U.S. In 1999, the U.S. spent an average of $70,000 per cancer case, compared with $44,000 in Europe. By assigning a standard figure to extra years lived, the researchers concluded that the value of survival in the U.S. outweighs the cost by an average $61,000 per case, which the researchers viewed as proof that higher health care spending in the U.S. is "worth it."

However, critics faulted the study for focusing on survival gains, which are among the most problematic cancer statistics, according to Reuters. Scoring health care with "improving survival" is misleading because it is subject to lead-time bias, which makes it appear that patients are living longer if they are diagnosed earlier and does not account for their total lifespan, critics noted (Begley, Reuters, 4/9).

Study Likens Cancer Study Funding to 'Ponzi Scheme'

In other related news, a new study published in the Journal of Clinical Oncology finds that cancer research within the National Cancer Institute's Clinical Trial Cooperative Group program is underfunded and inefficient, Reuters reports.

The study looked at 97 clinical trials conducted by the NCI program, two-thirds of which were cooperative group trials while the rest were industry-funded. The study found that cooperative trials -- where participants typically are provided initial payments -- lost money faster than industry trials, which distribute funds to patients throughout the study's duration.

In addition, researchers found that the NCI program often started new trials to pay for patients' follow-up costs in previous studies, which they likened to a "Ponzi scheme" (Norton, Reuters, 4/11).


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