Lacks Cancer Center’s CT scan detects early-stage lung cancer
Mercy Health’s lung cancer screening program is detecting early-stage lung cancer in West Michigan residents and is shouldering part of the cost for the preventive screening.
Mercy Health Lacks Cancer Center announced recently that more than 450 West Michigan residents who are at high risk for lung cancer have participated in the lung cancer screening program since May 2013, which has resulted in detecting more than a dozen early stage lung cancers.
The low-dose lung CT scan used by Lacks Cancer Center is able to detect lesions in the lungs smaller than one centimeter and has the equivalent radiation of a normal X-ray, according to a press release. The scan produces multiple images rather than a single image from an X-ray, which helps reduce lung cancer mortality by 12 to 20 percent through early detection, according to the National Lung Screening Trial study conducted by the American College of Radiology Imaging Network.
Kenda Klotz, clinical services director at Mercy Health Lacks Cancer Center, said the hospital followed the NLST study and was intrigued by how positive the outcomes were for those undergoing the trial.
“As it relates to prevention and screening, one of the most frustrating pieces as a cancer program is getting people diagnosed at a late stage,” said Klotz. “With lung cancer, that happened frequently because there are not a lot of signs and symptoms before people end up having a Stage 3 or Stage 4 cancer.”
The study began in 2002 with more than 50,000 current or former heavy smokers between the ages of 55 to 74 receiving three annual screens with either a low-dose lung CT scan or a standard X-ray. NLST’s findings indicated 24.2 percent of low-dose lung CT scans were positive, while only 6.9 percent of chest X-rays were positive.
When NLST released the results of the study, Klotz said the hospital wanted to pursue implementing a screening program since it looked like it could decrease lung cancer mortality.
“Over the course of my career, we have made very little in-roads in regard to that,” said Klotz. “We were very intrigued and really wanted to pursue it because as we take a look at the health of our community, it certainly is within our mission statement as well as vision for the future in health care that it needs to be about prevention, screening and trying to get to things as early as possible.”
When Lacks Cancer Center launched the program last spring, the hospital already had the equipment and radiology technologists on staff to perform the scans. Using the National Comprehensive Cancer Network’s definition of high risk to determine eligible patients, Lacks Cancer Center accepts individuals who are ages 55 to 80, current smokers, or former smokers who quit within the last 15 years, and who have a smoking history of at least 30 “pack-years.” One pack-year of smoking means having smoked one package of cigarettes daily for one year.
Although insurance companies are not billed for the procedure at this time and the out-of-pocket cost to patients is $99, a low-dose lung CT scan can cost up to $200 to $300, according to Klotz. Upon researching the typical costs across the country and the resulting low utilization rate of an average 30 screenings in 12 months, Lacks Cancer Center decided to absorb some of the cost.
“I was really quite frustrated with that. We had conversations between the radiologists and the executive team and landed on a $99 charge out-of-pocket for patients,” said Klotz. “So does that cover all the costs? It doesn’t, but at this point it honestly felt like the right thing to do and it is also being looked at from a national perspective as something that is going to be covered eventually with insurance. We really did not want to wait for that.”
Since Lacks Cancer Center began screening patients in May, roughly 457 people had received the scan as of Oct. 1, which resulted in detecting 13 early-stage lung cancers and incidental findings such as renal cancer and thyroid cancer.
“This has been very successful. It has been a little bit more successful than the clinical trial,” said Klotz. “We are seeing right around 2.5 to 2.7 percent of the people we screen are ending up with an early-stage lung cancer, and why we are excited about that is, those become very treatable and curable.”
The National Institutes of Health estimated the overall cost of cancer in 2009 reached a total of $216.6 billion, with indirect mortality costs attributed to lost productivity at $130 billion. In 2010, the National Cancer Institute released its Cancer Trends Progress Report for 2009 and 2010, which indicated lung cancer had the highest loss of lifetime earnings of roughly $36.1 billion.
Early detection and subsequent treatment absolutely saves money in the long run, Klotz said.
“It saves lives. From a community perspective, whenever you can keep people healthy, they can continue to work and continue to contribute to the community,” said Klotz. “It certainly is less costly to treat cancer at an early stage than a later stage because then we have to be much more aggressive in attempting to get the cancer.”
Mercy Health Lacks Cancer Center recently was named one of four Michigan-based Screening Centers of Excellence by the Lung Cancer Alliance based on a number of principles, including: provides clear information on who is a candidate for lung cancer screening; complies with comprehensive standards developed by NCCN; uses a multi-disciplinary team to coordinate continuum of care; and includes comprehensive smoking cessation program in its screening.