NLST data clearly demonstrate that lung cancer screening is effective and safe and reduces lung cancer-specific mortality by at least 20%. There is no possible reason for CMS to further delay or restrict lung cancer screening for those at high risk.
The development of CT lung cancer screening, the publication of results from the NLST in 2011, and the grade-B recommendation for CT lung cancer screening in high-risk smokers by the USPSTF raise a number of interesting national health policy issues.
The NLST is a landmark trial demonstrating that implementation of low-dose CT screening lowers lung cancer–related mortality. We must put the study results and cost-effectiveness analyses in the context of the staggering statistics: up to 65% of lung cancer patients present with advanced-stage disease where treatments are often costly, toxic, and only palliative in nature.
Expert radiologists were able to screen magnetic resonance images and rule out breast cancer diagnosis with a negative predictive value of about 99% using an abridged breast MRI protocol in a single-center study presented Saturday at the ASCO Breast Cancer Symposium 2013.
The debate over screening for lung cancer continues. While there have been many advances in treatment for late-stage disease, screening and prevention are likely the most cost effective and best approaches to preventing lung cancer deaths.