Lanni Thomas B, Stevens Craig, Farah Michael, Boyer Andrew, Davis James, Welsh Robert, Keena Daniel, Akhtar Adil, Mezwa Duane
Oncology Services.
Departments of Radiation Oncology.
Am J Clin Oncol. 2018 Mar;41(3):218-222. doi: 10.1097/COC.0000000000000254.
In 2010, a new study published by the National Lung Screening Trial showed a 20% reduction in mortality for those patients screened with low-dose computed topography (CT) versus x-ray. Recently, the Centers of Medicare and Medicaid have agreed to cover this service for those patients who meet the screening criteria. We compare the outcomes and costs associated with developing and implementing a lung cancer screening program.
One thousand sixty-five patients were screened from January 2014 to December 2014. These patients were screened on a low-dose CT screening protocol throughout Beaumont Health System. The American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS) were used to assign the score for each patient. Screening eligibility criteria were based on the National Comprehensive Cancer Network guidelines. Downstream activity and revenue was determined after initial low-dose CT screening.
At 1 year, 20 patients (1.6%) were diagnosed with lung cancer and another 15 patients were diagnosed with another form of cancer after screening. The median age, packs per day, and pack years smoked for all patients was 63, 1.0, and 39.0 years, respectively. Lung-RADS scores for all patients was 18% (1), 24.1% (2), 6.3% (3), and 5.4% (4). The net revenue for all activity after screening was $3.2 million.
The establishment of a low-dose CT lung cancer screening program improved the ability to screen patients as demonstrated by the number of patients screened and those diagnosed with a malignancy. These findings were also consistent with the findings from the National Lung Screening Trial study.
2010年，国家肺癌筛查试验发表的一项新研究表明，与接受X线检查的患者相比，接受低剂量计算机断层扫描（CT）筛查的患者死亡率降低了20%。最近，医疗保险和医疗补助服务中心已同意为符合筛查标准的患者提供这项服务。我们比较了开展和实施肺癌筛查项目的结果及成本。
2014年1月至2014年12月期间对1065例患者进行了筛查。这些患者在博蒙特医疗系统中按照低剂量CT筛查方案进行筛查。采用美国放射学会肺部影像报告和数据系统（Lung-RADS）为每位患者打分。筛查资格标准基于美国国立综合癌症网络指南。在初次低剂量CT筛查后确定后续活动及收入情况。
1年后，20例患者（1.6%）被诊断为肺癌，另有15例患者在筛查后被诊断为其他类型癌症。所有患者的中位年龄、每日吸烟包数和吸烟包年数分别为63岁、1.0包和39.0年。所有患者的Lung-RADS评分分别为18%（1级）、24.1%（2级）、6.3%（3级）和5.4%（4级）。筛查后所有活动的净收入为320万美元。
低剂量CT肺癌筛查项目的建立提高了筛查患者的能力，这从筛查患者数量及诊断为恶性肿瘤的患者数量中得到了体现。这些发现也与国家肺癌筛查试验研究的结果一致。
