Ending the Stigma

U.S. Preventive Services Task Force's lung screening recommendations are a welcome step to ensure that individuals at high-risk for lung cancer have access to a simple scan that is proven to save lives.
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By Gregory Sorensen, M.D., and Laurie Fenton Ambrose

Thanks to advances in medicine that have helped physicians detect, diagnose, treat and monitor cancers with unprecedented success, we have transformed many cancer diagnoses from a sure death sentence to a roadmap for survival.

Unfortunately that hasn't been the case for lung cancer. With all the innovative treatments developed over the last two decades, lung cancer's five-year survival rate is still only 16 percent -- a mere three percent above where it was almost 40 years ago, when the "War on Cancer" was launched.

Lung cancer ranks as the deadliest cancer, killing more than any other cancer globally -- and claiming more 160,000 lives annually in the United States. And despite accounting for more deaths than the next four leading causes of cancer death (breast, prostate, colon and pancreatic cancers) combined, lung cancer has not gotten a proportional level of attention or funding compared to other cancers.

From research funding to early-detection insurance coverage, the stigma that smokers somehow "deserve what they get" has too frequently permeated the battle against this particular form of cancer. This sort of thinking is just wrong. Just as we don't deny care to the skier who broke her leg on the slopes, or to the morbidly obese patient with coronary artery disease, or even treatment to lung cancer victims once the cancer is discovered, why would we deny life-saving early detection to lung cancer patients?

We shouldn't and now, finally, the tide may be turning.

The U.S. Preventive Services Task Force (USPSTF) announced its draft recommendations supporting low-dose computed tomography scans (LDCT) for individuals who are, or were, heavy smokers.

The USPSTF recommendation, which applies to individuals 55 to 80 years of age who have a 30 pack year or greater history of smoking, and who are either current smokers or have quit in the past 15 years, is based in part on the landmark National Lung Screening Trial (NLST) study, which found that LDCT significantly reduced lung cancer deaths among current and former smokers aged 55 to 74 years and has the potential to save tens of thousands of lives.

If deployed properly, a relatively simple intervention -- a CT scan -- has the potential to decrease lung cancer death rates by 20 percent.

That's why the Task Force's draft recommendation is such an important milestone. The USPSTF's endorsement clears the way to responsibly increase access to CT screening for those at high-risk for lung cancer so they -- just like those with other cancers -- may reap the tremendous benefits of early detection. Hopefully, the Centers for Medicare & Medicaid Services will take the necessary next step of expanding Medicare coverage of this service for those at risk.

Regardless of when Medicare ultimately decides to cover CT scanning for those at-risk of lung cancer, it is critical that patients and physicians continue to follow evidence-based guidelines to ensure responsible use of the technology. Organizations such as the National Comprehensive Cancer Network, an alliance of the world's leading cancer centers, the American Cancer Society and the American Lung Association have all developed clinical guidelines for physicians and patients to help determine who should be scanned and when they should undergo the test. To responsibly deploy this technology, it is vital these clinical guidelines are followed.

The USPSTF's lung screening recommendations are a welcome step to ensure that individuals at high-risk for lung cancer have access to a simple scan that is proven to save lives.

By Gregory Sorensen, M.D., chief executive officer, Siemens Healthcare North America and Laurie Fenton Ambrose, president and CEO, Lung Cancer Alliance.

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