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Correspondence |

Lung Cancer ScreeningLung Cancer Screening FREE TO VIEW

Carla R. Lamb, MD, FCCP; Andrea B. McKee, MD; Brady J. McKee, MD; Anthony Campagna, MD, FCCP; Paul J. Hesketh, MD
Author and Funding Information

From the Department of Pulmonary and Critical Care (Drs Lamb and Campagna), the Department of Radiation Oncology (Dr A. McKee), the Department of Radiology (Dr B. McKee), and the Department of Medical Oncology (Dr Hesketh), Lahey Clinic.

Correspondence to: Carla R. Lamb, MD, FCCP, Lahey Clinic, Pulmonary and Critical Care Department, 41 Mall Rd, Burlington, MA 01805; e-mail: Carla.R.Lamb@lahey.org


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(5):1737. doi:10.1378/chest.13-1539
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Published online
To the Editor:

Although we agree with a statement by Detterbeck et al1 in the American College of Chest Physicians (ACCP) lung cancer screening guideline in a recent issue of CHEST (May 2013) that, “The cost of the process of [CT lung] screening should be reimbursed fairly,” the authors’ assertion that “establishing a discounted rate as a strategy to capture patients…creates a structure that can increase harms from excessive investigation of benign nodules” is speculation without sufficient support to be included in an evidence-based guideline statement.

Screening high-risk individuals with low-dose chest CT (LDCT) scans saves lives and is endorsed by nine national medical societies, including the American Cancer Society, with the largest impact on cancer deaths resulting from a single intervention in several decades.1-3 Self-pay presents a significant economic barrier for qualified patients. Free screening is an interim measure to provide equitable access. McKee et al’s4 recent article in the Journal of the American College of Radiology describes an ongoing National Comprehensive Cancer Network Guidelines-based free LDCT scan lung screening program demonstrating initial results similar to those reported in the National Lung Screening Trial.5 Free LDCT scan lung screening achieves the goals of the Affordable Care Act.

References

Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB. Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5_suppl):e78S-e92S. [CrossRef] [PubMed]
 
Statement from the American Society of Clinical Oncology and the American College of Chest Physicians on the joint systematic review and clinical practice guideline on the role of CT screening for lung cancer (endorsed by the American Thoracic Society). American Society of Clinical Oncology website. http://www.asco.org/ASCOv2/Press+Center/Latest+News+Releases/General+News+Releases/Statement+from+the+American+Society+of+Clinical+Oncology+and+the+American+College+of+Chest+Physicians+on+the+Joint+Systematic+Review+and+Clinical+Practice+Guideline+on+the+Role+of+CT+Screening+for+Lung+Cancer+%28Endorsed+by+the+American+Thoracic+Society%29. Updated May 20, 2012. Accessed December 26, 2012.
 
National Comprehensive Cancer Network. NCCN guidelines for lung cancer screening (V.1.2012). National Comprehensive Cancer Network website. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed December 24, 2012.
 
McKee BJ, McKee AB, Flacke S, Lamb CR, Hesketh PJ, Wald C. Initial experience with a free, high-volume, low-dose CT lung cancer screening program. J Am Coll Radiol. 2013;10(8):586-592. [CrossRef] [PubMed]
 
Aberle DR, Adams AM, Berg CD, et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. [CrossRef] [PubMed]
 

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References

Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB. Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5_suppl):e78S-e92S. [CrossRef] [PubMed]
 
Statement from the American Society of Clinical Oncology and the American College of Chest Physicians on the joint systematic review and clinical practice guideline on the role of CT screening for lung cancer (endorsed by the American Thoracic Society). American Society of Clinical Oncology website. http://www.asco.org/ASCOv2/Press+Center/Latest+News+Releases/General+News+Releases/Statement+from+the+American+Society+of+Clinical+Oncology+and+the+American+College+of+Chest+Physicians+on+the+Joint+Systematic+Review+and+Clinical+Practice+Guideline+on+the+Role+of+CT+Screening+for+Lung+Cancer+%28Endorsed+by+the+American+Thoracic+Society%29. Updated May 20, 2012. Accessed December 26, 2012.
 
National Comprehensive Cancer Network. NCCN guidelines for lung cancer screening (V.1.2012). National Comprehensive Cancer Network website. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed December 24, 2012.
 
McKee BJ, McKee AB, Flacke S, Lamb CR, Hesketh PJ, Wald C. Initial experience with a free, high-volume, low-dose CT lung cancer screening program. J Am Coll Radiol. 2013;10(8):586-592. [CrossRef] [PubMed]
 
Aberle DR, Adams AM, Berg CD, et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. [CrossRef] [PubMed]
 
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