How does a patient with a history of smoking obtain yearly computed tomography (CT) scans?

From the Guidelines

Patients with a history of smoking should obtain yearly low-dose computed tomography (CT) scans if they meet specific criteria, including being aged 55-74 years with a 30 pack-year smoking history, or aged 50-79 years with a 20 pack-year smoking history and additional comorbid conditions that produce a cumulative risk for cancer of at least 5% over the next 5 years. The recommendation for yearly CT scans is based on guidelines from the American Association for Thoracic Surgery, the American Cancer Society, and the National Comprehensive Cancer Network, as outlined in studies such as 1 and 1. These guidelines emphasize the importance of annual screening with low-dose CT in high-risk patients who are in relatively good health.

Key points to consider for eligibility include:

• Age: 55-74 years for those with a 30 pack-year smoking history, or 50-79 years for those with a 20 pack-year smoking history and additional comorbid conditions
• Smoking history: at least 30 pack-years, or at least 20 pack-years with additional comorbid conditions
• Current smoking status: current smokers or those who have quit within the past 15 years
• Comorbid conditions: presence of conditions that increase the cumulative risk for cancer

It is essential for patients to discuss their complete smoking history and any other risk factors with their healthcare provider to determine if they qualify for this preventive measure, as recommended by 1. Insurance, including Medicare, typically covers this screening for eligible individuals. The low-dose CT scan uses minimal radiation to create detailed images of the lungs, allowing doctors to detect small nodules or abnormalities that might indicate early-stage lung cancer before symptoms develop. Early detection of lung cancer significantly improves survival rates, making yearly CT scans a crucial tool for patients with a history of smoking who meet the specified criteria.

From the Research

Eligibility Criteria for Yearly CT Scans

To obtain yearly computed tomography (CT) scans, a patient with a history of smoking must meet certain eligibility criteria. The US Preventive Services Task Force (USPSTF) recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years 2.

Screening Process

The screening process typically involves a low-dose helical computed tomography (CT) scan with 1.0 mm to 1.25 mm collimation 3. The results of the scan are then followed according to a specific protocol, which may include annual repeat scans, 3-month follow-up scans, or immediate further testing such as contrast-enhanced CT or CT-guided biopsy 3.

Benefits of Screening

The benefits of yearly CT scans for patients with a history of smoking include early detection of lung cancer, which can improve treatment outcomes and reduce mortality rates 2, 4, 5. The USPSTF concludes that annual screening for lung cancer with LDCT has a moderate net benefit in persons at high risk of lung cancer based on age, total cumulative exposure to tobacco smoke, and years since quitting smoking 2.

Integration with Smoking-Cessation Services

Yearly CT scans can also be paired with smoking-cessation services to encourage patients to quit smoking and reduce their risk of lung cancer and other smoking-related health problems 6. Smokers who present for lung cancer screening should be encouraged to quit smoking at each visit, and access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results 6.

Key Points to Consider

• Patients must meet specific eligibility criteria, including age and smoking history, to qualify for yearly CT scans 2.
• The screening process typically involves a low-dose CT scan, with follow-up testing and treatment as needed 3.
• Yearly CT scans can improve treatment outcomes and reduce mortality rates for patients with lung cancer 2, 4, 5.
• Smoking-cessation services can be integrated with CT scans to encourage patients to quit smoking and reduce their risk of lung cancer and other health problems 6.