How do I decide?
Ideally, the decision on whether to be screened or not should be made with the help of your primary care doctor. Your doctor knows your history and possible risk factors best. And, your doctor can help guide you to the right site and ask questions of the site in advance on your behalf.
Some screening sites require a doctor’s prescription in advance for a scan. Other sites will do an evaluation without a prescription to determine if an individual’s history and risk factors warrant a scan.
Where do I go?
Only go to an experienced site:
- That follows an organized plan - a proven regimen or protocol – that is updated to incorporate new technology and knowledge, such as the one developed by International Early Lung Cancer Action Program (I-ELCAP)**, for subsequent diagnostic testing when a nodule is found on the screening scan;
- That has a commitment to a high-quality screening program with adequate staff and resources;
- That will have the scans read by an American Board of Radiology board certified radiologist with special training and expertise in lung cancer screening;
- That is accredited in CT by a certifying organization, such as the American College of Radiology;
- That has modern multi-slice CT scanning equipment managed to provide high-quality, low-dose, and non-contrast spiral CT scans.
- That is part of or affiliated with a health care facility which has expertise and excellence in radiographic and/or endoscopic biopsy techniques and which has board certified pulmonary medicine and thoracic surgical practitioners with special interest and expertise in the diagnosis and treatment of lung cancers diagnosed in screening programs.
You will need a prescription from your primary care doctor who can also help guide you to the right site and ask questions of the site in advance on your behalf.
Experienced Sites
Experienced sites include:
- All National Cancer Institute Cancer Center sites:
http://cancercenters.cancer.gov/cancer_centers/cancer-centers-list.html - All International Early Lung Cancer Action program (I-ELCAP) sites:
http://www.ielcap.org/members/memberlist.php
- Certain VA Sites
The Phoenix VA Legacy-ELCAP Study
Phoenix VA Health Care System
650 E. Indian School Road (RS/151)
Phoenix, AZ 85012-1892
http://www.phoenix.va.gov
Arizona
St. Joseph’s Hospital and Medical Center
Center for Thoracic and Esophageal Disease
350 West Thomas Road
Phoenix, Arizona 85013
1- 855-LUNG-SCREEN (1-855-586-4727)
http://www.stjosephs-phx.org/Medical_Services/Center_for_Thoracic_and_Esophageal_Disease/219499
California
UCLA Health System
Ronald Reagan UCLA Medical Center
200 Medical Plaza, Suite #120
(310) 794-7333
Los Angeles, CA 90095http://lungcancer.ucla.edu/lung_screening_clinic.html
District of Columbia
MedStar Health: call 888-666-3432 for information on screening at the following MedStar Health Hospitals:
http://www.medstarhealth.org/body.cfm?id=557085
Georgetown University Hospital
3800 Reservoir Road, NW | Washington, DC 20007 | 202-342-2400
Washington Hospital Center
110 Irving Street, NW · Washington, DC 20010 · (202) 877-7000
Florida
Moffitt Cancer Center
12902 Magnolia Drive, Tampa, FL 33612
http://www.moffitt.org/Site.aspx?spid=9A87540E3F1E48BFB124669B46B01AC7
813-745-3980 or 1-888-860-2778.
Georgia
Emory University Hospital
Various sites
Atlanta. Georgia
404-686-LUNG (404-686-5864)
http://www.emoryhealthcare.org/radiology/procedures/lung-ct/index.html
WellStar Health System
Lung Cancer Screening Program
522 North Ave
Marietta, Georgia 30060
Program Coordinator: Vickie Beckler, RN 678-594-4302
Email: vickie.beckler@wellstar.org
Lung screening available at Austell, Douglasville, East Cobb, Hiram,
Marietta and Woodstock.
(Logo with link)
http://www.wellstar.org/education/pages/low-dose-ct-lung-cancer-screening.aspx
Call 770-956-STAR (7827).
Maryland
MedStar Health Hospitals:
http://www.medstarhealth.org/body.cfm?id=557085
call 888-666-3432 for information on screening at the following
Franklin Square Hospital Center
9000 Franklin Square Drive
Baltimore, MD 21237
Good Samaritan Hospital of Maryland
5601 Loch Raven Boulevard
Baltimore, MD 21239 | 443.444.8000
Harbor Hospital
3001 S. Hanover St
Baltimore, MD 21225
Montgomery General Hospital
18101 Prince Philip Drive
Olney, Maryland 20832
http://www.montgomerygeneral.org/body.cfm?id=455
St. Mary's Hospital
25500 Point Lookout Road
Leonardtown, Maryland 20650
301-475-8981
http://www.medstarhealth.org/body.cfm?id=557085
Union Memorial Hospital
201 East University Parkway
Baltimore, MD 21218 410.554.2000
Massachusetts
Brigham and Women’s Hopsital
Harvard Medical School
Coolidge Corner Imaging
356 Harvard Street
Brookline, MA 02446
for lung screening call: 617-383-6585
http://www.brighamandwomens.org/Departments_and_Services/radiology/ClinicalTrials/default.aspx
North Carolina
Wake Forest Baptist Medical Center
Medical Center Boulevard
Winston-Salem, NC 27157
call: 1-877-243-0563.
http://www.wakehealth.edu/Imaging/Services/CT-Lung-Screening-FAQ.htm
Texas
MD Anderson Cancer Center
1515 Holcombe Blvd.
Houston, TX 77030
call first for pre-screening information: 1-877-MDA-6789
http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-topics/prevention-and-screening/cancer-screening-guidelines/lung-cancer.html
Washington
Swedish Medical Center
5300 Tallman Ave. N.W.
Seattle, WA 98107-3932
call (206) 292-7700; e-mail inquiries:
http://www.swedish.org/Services/Thoracic-Surgery/Thoracic-Surgery-Services/Lung-Cancer-Screening/Current-Former-Smokers-ELCAP
This list will be updated on a regular basis as information on additional sites following best practices is made available to us.
Is CT screening covered by insurance?
WellPoint, one of the largest commercial insurance companies in the country, announced in November, 2011 that CT scans for those at high risk for lung cancer would be covered as a benefit under their plans. For additional information: http://www.wellpoint.com.
Medicare does cover CT scans to diagnose lung cancer in a Medicare-eligible person with symptoms ($300 on average), but Medicare does not yet cover CT scans to screen a person without symptoms for lung cancer .
This may change when the U.S.Preventive Services Task Force (USPSTF) revises its recommendations on CT screening for lung cancer. The current recommendation is neutral - an “I” rating -which stands for “insufficient evidence to recommend for or against.” (PSA testing for prostate cancer carries the same “I” recommendation.) However, since NCI’s large scale randomonized trial has shown such a positive mortality benefit for screening people at high risk for lung cancer, this 2004 rating must be changed.
Medicare and insurance companies generally follow USPSTF recommendations in making coverage decisions. The new healthcare law will make coverage mandatory only for procedures with an “A” or a “B” USPSTF recommendation.
In November, 2010, immediately after the results of the NLST were released, Lung Cancer Alliance asked the USPSTF for an immediate review of the new findings. In response, the USPSTF said a revised recommendation would be available for public comment in early 2012. LCA and others are continuing to press for expedited action.
Is CT screening cost effective?
The cost of treating late stage lung cancer is twice that of finding and curing early stage lung cancer, and almost inevitably futile. The cost and risk involved in screening a large block of people at high risk for lung cancer are high but must be weighed against the high treatment costs and the value of lives lost to late stage cancers.
An actuarial (insurance) study by Milliman Inc. commissioned by Lung Cancer Alliance and American Legacy Foundation demonstrated that CT screening for lung cancer could be more cost-effective (lower cost per year of live saved) than breast, cervical or colon cancer screening. The cost of including CT lung cancer screening as a covered benefit under commercial plans would be less than $1 per member per month.
Another previous actuarial study by Milliman of 350,000 lung cancer mortality records completed in 2009 demonstrated that early diagnosis would save 70,000 lives a year, and that those treated promptly would not only be cured but would be eligible for life insurance.
For information on the Milliman study, visit www.lungcanceralliance.org.
What will happen now with lung cancer screening?
We are in the midst of a healthcare cost and quality crisis. Lung cancer screening is a major new approach that could save many lives but present challenges to our current healthcare system. Additional research could allow a better understanding of how to most optimally deliver safe and effective lung cancer screening in routine care settings. This requires definition of who is best equipped to provide the care as well as what the best process is to deliver the service. Progress with these issues may reduce cost and ensure that high quality screening services can be provided to all at-risk individuals across our country.
