Computed Tomography (CT) Scanning for Lung Cancer Screening
DESCRIPTION
Given the poor prognosis of lung cancer, there has been long-standing research interest in developing screening techniques for those at high risk. Previous studies of serial sputum samples or chest x-rays failed to demonstrate that these screening techniques improved health outcomes. There has been interest in CT scanning as a screening technique, using either spiral (also referred to as helical) or electron beam (also referred to as ultrafast). Compared to conventional CT scanning, these CT scans allow for the continuous acquisition of images, thus shortening the scan time and radiation exposure. A complete spiral or electron beam CT scan can be obtained within 10-20 seconds, or during one breath hold, in the majority of patients. The radiation exposure for this exam is greater than for that of a chest x-ray, but much less than for a conventional CT scan.
POLICY
Computed tomography scanning (e.g., helical or ultrafast electron beam) as a screening technique for lung cancer is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
There is a lack of controlled scientific studies documenting the safety and efficacy of computed tomography for lung cancer screening. The literature does not determine if this technology will reduce lung cancer mortality rates.
SOURCES
International Early Lung Cancer Action Program Investigators, Henschke, C. I., Yankelevitz, D. F., Libby, D. M., Pasmantier, M. W., Smith, J. P., et al. (2006). Survival of patients with stage I lung cancer detected on CT screening. New England Journal of Medicine, 355 (17), 1763-1771.
Mulshine, J. L., & Sullivan, D. C. (2005). Lung cancer screening. New England Journal of Medicine, 352 (26), 2714-2720.
Petersen, R. P., & Harpole, D. H. (2006). Computed tomography screening for the early detection of lung cancer. Journal of the National Comprehensive Cancer Network, 4 (6), 591-594. Abstract retrieved September 16, 2010 from PubMed database.
ORIGINAL EFFECTIVE DATE: 10/1/2003
MOST RECENT REVIEW DATE: 11/17/2011
ID_MS
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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