Medicare and Medicaid to Pay for Lung-Cancer Screening CT Studies

On Thursday, it became official. According to the Centers for Medicare and Medicaid Services (CMS), effective immediately, adults between the ages of 55 and 77 who are smokers or who stopped smoking with the past 15 years but had been at the “30 pack-years” level are eligible for annual lung cancer screening CT scans-paid for by Medicare and Medicaid. Often, this type of pronouncement spreads into private insurance as well….we’ll learn soon enough.

What does this mean? Well, clearly the research showed that the mortality rate and costs associated with treating advanced lung cancer can be reduced by implementing this screening for early detection. As lung cancer is the third most prevalent form in the U.S., the American Cancer Society estimates, the disease will cause 158,000 deaths in the U.S. this year (1). In addition to those deaths, 221,200 new cases are diagnosed each year. Of those newly diagnosed, 67% are 65 years or older; 98% are over 45.

Based on this data, it seems these guidelines, which have been under consideration for several years, are well-founded. To put the impact of this decision into perspective, consider that a low-dose spiral CT scan can reveal lung abnormalities the size of a grain of rice(2).

What else does this mean? It is a safe assumption that there will be a surge in medical imaging data that will develop from this newly-insured procedure, which many institutions will keep in the patient record indefinitely. In diagnosing cancer, past studies are especially critical for comparative purposes. An uncompressed multi-slice CT study requires between 131MB and 2.1 GB of storage (3).

According to data from the Kaiser Family Foundation (4), in 2012, over 49 million Americans were enrolled in Medicare alone; Medicaid enrollees add close to a million more. Granted, not all smoke or have smoked, but a simple calculation yields the estimate that 50 million-plus screening CT studies would generate 100PB of data that would need to be kept for a bare minimum of five years. Even if only 1/3 of enrollees qualify for the screening, it’s still a massive amount of new data to manage.

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