Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts 01805, USA.
J Am Coll Radiol. 2013 Aug;10(8):586-92. doi: 10.1016/j.jacr.2013.02.015. Epub 2013 Apr 26.
The National Lung Screening Trial demonstrated a significant mortality benefit for patients at high risk for lung cancer undergoing serial low-dose CT. Currently, the National Comprehensive Cancer Network and several United States-based professional associations recommend CT Lung screening for high-risk patients. In the absence of established reimbursement, the authors modeled and implemented a free low-dose CT lung cancer screening program to provide equitable access to all eligible patients. Elements of the program reported in this article include a decentralized referral network, centralized program coordination, structured reporting, and a patient data management system. The experience and initial results observed in this clinical setting closely match the performance metrics of the National Lung Screening Trial with regard to cancer detection and incidental findings rates. To eliminate health care disparities a vigorous lobbying effort will be needed to expedite reimbursement and make CT lung screening equally available to all patients at high-risk.
国家肺癌筛查试验表明,对高危肺癌患者进行连续低剂量 CT 检查可显著降低死亡率。目前,美国国家综合癌症网络和几家美国专业协会建议对高危患者进行 CT 肺癌筛查。在没有既定报销的情况下,作者建立并实施了一项免费的低剂量 CT 肺癌筛查计划,为所有符合条件的患者提供公平的机会。本文报告的该计划的内容包括分散的转诊网络、集中的计划协调、结构化报告和患者数据管理系统。在这种临床环境中观察到的经验和初步结果与国家肺癌筛查试验在癌症检出率和偶然发现率方面的性能指标非常吻合。为了消除医疗保健方面的差异,需要大力游说以加快报销速度,并使所有高危患者都能平等地获得 CT 肺癌筛查。