Thoracic Surgery News (Archived)

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

San Francisco – The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTDB) is the largest clinical thoracic surgical database in the United States. However, it is not known whether the outstanding outcomes for esophageal cancer resection from the GTDB are representative of nationwide results, said Dr. Benjamin D. Kozower at the annual meeting of the American Association for Thoracic Surgery. He and his colleagues at the University of Virginia performed a study to see if GTDB esophagectomy outcomes are representative of nationwide outcomes by comparing them to other national clinical and administrative databases.

From 2002 to 2008, esophageal cancer resection outcomes from the GTDB were compared with the National Surgery Quality Improvement Program (NSQIP) and the Nationwide Inpatient Sample (NIS), the largest all-payer, inpatient care database in the United States. Primary outcomes were the number of procedures reported from each database and differences in mortality and resource utilization. Observed differences in patient characteristics and postoperative events were also analyzed.

Annual esophageal resection volume has increased over time. However, the GTDB (n = 6,740) and NSQIP (n = 1,030) capture only a small proportion of resections performed nationally: 30% and 5%, respectively. Median patient age was between 64 and 65 years; between 18% and 21% were women, similar in all three databases. Mortality was significantly lower within the GTDB (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%). In addition, the median length of stay was lower in the GTDB (10 days) compared with both the NSQIP (12 days) and NIS (12 days).

"The STS GTDB reports outstanding mortality results and hospital resource utilization for esophageal cancer resection. However, surgical outcomes from the STS GTDB are not representative of national results from programs not participating in the database," said Dr. Kozower.

"These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and utilization of the STS GTDB," he concluded.

WASHINGTON – Members of the Medicare Payment Advisory Commission expressed concern about the burden placed on smaller practices by the requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Physicians who meet requirements for the meaningful use of an electronic health record (EHR) can earn incentive payments of up to $44,000 under HITECH. Starting in 2015, physicians who do not participate will be penalized.

One thing the incentive pay does not cover, according to Commissioner Peter Butler, is the time necessary to manage all the additional data requirements."What [incentives] do not do is provide dollars for decision support, for data repositories, data warehouses, which are really the heart of managing in an [accountable care organization] capitated world. It kind of ignores some of the real tools that ultimately you need to kind of make a difference," said Mr. Butler, president and chief operating officer at Rush University Medical Center, Chicago.

Dr. Karen Borman, a MedPAC commissioner, added that the additional data requirements are also forcing physicians to spend more time in front of the computer instead of interacting with the patient.

As data requirements increase, the commission should consider how to address that concern in terms of patient satisfaction, noted Dr. Borman, a surgeon at Abington (Pa.) Memorial Hospital.

Despite the flaws in the EHR incentive program, commissioners agreed that, if it’s done right, EHRs would benefit both physicians and patients.

MedPAC Commissioner Dr. William Hall of the University of Rochester (N.Y.), noted that EHR systems support a higher level of coding, which would mean higher payments to physicians than even incentive payments could offer.

Joanna Kim, senior associate director of the American Hospital Association, Washington, testified to the commission that EHR requirements are too challenging, even for hospitals.

"[Incentive payments] are slow to come because the stage one requirements were set entirely too high," Ms. Kim said. She added that certain elements, like the patient portal are too expensive to implement, cause major security concerns, and carry uncertain benefits.

CMS penalties for failing to meet meaningful use requirements will not hit until 2015, but they’ll be based on 2013 performances. As well as examining the EHR incentive program, the commission unanimously recommended changes to Medicare fee-for-service benefit design, including:

• Establishing a limit for out-of-pocket expenses to protect beneficiaries who reach catastrophic levels of Medicare costs. Although the commission recognized that a small group of beneficiaries would reach the out-of-pocket cap in any given year, they said many more would benefit from the cap.

• Replacing coinsurance (where the beneficiary pays a percentage of the fee) with copayments (where the beneficiary pays a proscribed fee per service) that vary according to the type of service and provider. According to MedPAC staffers, copayments are more predictable, easier to budget for, and easier to understand than is coinsurance.

• Placing an additional charge on private supplemental insurance, or Medigap, that pays for services not covered under Medicare. The commission said the charge would help recoup some of the added costs of Medicare.

• Allow the HHS secretary to determine cost sharing based on evidence of service value.

• Maintaining a deductible for Part A and Part B services.

The recommendations were included in the commission’s June report.

WASHINGTON – Members of the Medicare Payment Advisory Commission expressed concern about the burden placed on smaller practices by the requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Physicians who meet requirements for the meaningful use of an electronic health record (EHR) can earn incentive payments of up to $44,000 under HITECH. Starting in 2015, physicians who do not participate will be penalized.

One thing the incentive pay does not cover, according to Commissioner Peter Butler, is the time necessary to manage all the additional data requirements."What [incentives] do not do is provide dollars for decision support, for data repositories, data warehouses, which are really the heart of managing in an [accountable care organization] capitated world. It kind of ignores some of the real tools that ultimately you need to kind of make a difference," said Mr. Butler, president and chief operating officer at Rush University Medical Center, Chicago.

Dr. Karen Borman, a MedPAC commissioner, added that the additional data requirements are also forcing physicians to spend more time in front of the computer instead of interacting with the patient.

As data requirements increase, the commission should consider how to address that concern in terms of patient satisfaction, noted Dr. Borman, a surgeon at Abington (Pa.) Memorial Hospital.

Despite the flaws in the EHR incentive program, commissioners agreed that, if it’s done right, EHRs would benefit both physicians and patients.

MedPAC Commissioner Dr. William Hall of the University of Rochester (N.Y.), noted that EHR systems support a higher level of coding, which would mean higher payments to physicians than even incentive payments could offer.

Joanna Kim, senior associate director of the American Hospital Association, Washington, testified to the commission that EHR requirements are too challenging, even for hospitals.

"[Incentive payments] are slow to come because the stage one requirements were set entirely too high," Ms. Kim said. She added that certain elements, like the patient portal are too expensive to implement, cause major security concerns, and carry uncertain benefits.

CMS penalties for failing to meet meaningful use requirements will not hit until 2015, but they’ll be based on 2013 performances. As well as examining the EHR incentive program, the commission unanimously recommended changes to Medicare fee-for-service benefit design, including:

• Establishing a limit for out-of-pocket expenses to protect beneficiaries who reach catastrophic levels of Medicare costs. Although the commission recognized that a small group of beneficiaries would reach the out-of-pocket cap in any given year, they said many more would benefit from the cap.

• Replacing coinsurance (where the beneficiary pays a percentage of the fee) with copayments (where the beneficiary pays a proscribed fee per service) that vary according to the type of service and provider. According to MedPAC staffers, copayments are more predictable, easier to budget for, and easier to understand than is coinsurance.

• Placing an additional charge on private supplemental insurance, or Medigap, that pays for services not covered under Medicare. The commission said the charge would help recoup some of the added costs of Medicare.

• Allow the HHS secretary to determine cost sharing based on evidence of service value.

• Maintaining a deductible for Part A and Part B services.

The recommendations were included in the commission’s June report.

WASHINGTON – Members of the Medicare Payment Advisory Commission expressed concern about the burden placed on smaller practices by the requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Physicians who meet requirements for the meaningful use of an electronic health record (EHR) can earn incentive payments of up to $44,000 under HITECH. Starting in 2015, physicians who do not participate will be penalized.

One thing the incentive pay does not cover, according to Commissioner Peter Butler, is the time necessary to manage all the additional data requirements."What [incentives] do not do is provide dollars for decision support, for data repositories, data warehouses, which are really the heart of managing in an [accountable care organization] capitated world. It kind of ignores some of the real tools that ultimately you need to kind of make a difference," said Mr. Butler, president and chief operating officer at Rush University Medical Center, Chicago.

Dr. Karen Borman, a MedPAC commissioner, added that the additional data requirements are also forcing physicians to spend more time in front of the computer instead of interacting with the patient.

As data requirements increase, the commission should consider how to address that concern in terms of patient satisfaction, noted Dr. Borman, a surgeon at Abington (Pa.) Memorial Hospital.

Despite the flaws in the EHR incentive program, commissioners agreed that, if it’s done right, EHRs would benefit both physicians and patients.

MedPAC Commissioner Dr. William Hall of the University of Rochester (N.Y.), noted that EHR systems support a higher level of coding, which would mean higher payments to physicians than even incentive payments could offer.

Joanna Kim, senior associate director of the American Hospital Association, Washington, testified to the commission that EHR requirements are too challenging, even for hospitals.

"[Incentive payments] are slow to come because the stage one requirements were set entirely too high," Ms. Kim said. She added that certain elements, like the patient portal are too expensive to implement, cause major security concerns, and carry uncertain benefits.

CMS penalties for failing to meet meaningful use requirements will not hit until 2015, but they’ll be based on 2013 performances. As well as examining the EHR incentive program, the commission unanimously recommended changes to Medicare fee-for-service benefit design, including:

• Establishing a limit for out-of-pocket expenses to protect beneficiaries who reach catastrophic levels of Medicare costs. Although the commission recognized that a small group of beneficiaries would reach the out-of-pocket cap in any given year, they said many more would benefit from the cap.

• Replacing coinsurance (where the beneficiary pays a percentage of the fee) with copayments (where the beneficiary pays a proscribed fee per service) that vary according to the type of service and provider. According to MedPAC staffers, copayments are more predictable, easier to budget for, and easier to understand than is coinsurance.

• Placing an additional charge on private supplemental insurance, or Medigap, that pays for services not covered under Medicare. The commission said the charge would help recoup some of the added costs of Medicare.

• Allow the HHS secretary to determine cost sharing based on evidence of service value.

• Maintaining a deductible for Part A and Part B services.

The recommendations were included in the commission’s June report.

The federal government plans to delay for 1 year a requirement that doctors and other health care providers begin using the ICD-10 standard for diagnosis and procedure codes for 1 year. Physicians will now have until Oct. 1, 2014, to come into compliance with the standard.

Federal officials are also hoping to ease administrative burdens by requiring health plans to use a single, uniform identifier for all their transactions. Both changes were addressed in a proposed rule released this spring.

Health and Human Services Secretary Kathleen Sebelius announced earlier this year that the health care community would get more time to get up to speed on ICD-10 (formally known as the International Classification of Diseases, 10th Revision), but the proposed rule firms up that commitment.

Many physician organizations, including the American Medical Association, complained to the HHS and members of Congress, arguing that the implementation of the ICD-10 codes will create a significant burden. And it would carry a hefty price tag – close to $100,000 for smaller practices and more than $2 million for large ones, according to the AMA.

Part of the problem, according to the HHS, is that medical practices are having trouble meeting the compliance deadline for a necessary prerequisite for ICD-10, the Associated Standard Committee’s X12 Version 5010 standards (Version 5010) for electronic health care transactions. Moving the compliance deadline for the so-called 5010 standard from October 2013 to October 2014 will give physicians more time to prepare and test their systems, the HHS wrote in its proposed rule.

The proposed rule also outlines a related measure: a plan to require health insurers to adopt a standard national unique health plan identifier, or HPID. Currently, health plans use multiple identifiers of differing lengths and formats. The vagaries of these identifiers can cause improper routing of transactions, difficulty in determining patient eligibility, and other claims processing errors. Health insurers must begin to use the standardized HPID by Oct. 1, 2012.

The use of a unique identifier will allow medical practices to make greater use of automation in claims processing, according to the proposed rule, in turn saving time and money. And, cleaner claims with fewer errors should compound the savings. HHS officials estimate that over 10 years, the return on investment for the entire health care industry will be between $700 million and $4.6 billion. The adoption of the unique health plan identifier is one of a series of regulations mandated by the Affordable Care Act and aimed at simplifying health care administrative transactions.

The federal government plans to delay for 1 year a requirement that doctors and other health care providers begin using the ICD-10 standard for diagnosis and procedure codes for 1 year. Physicians will now have until Oct. 1, 2014, to come into compliance with the standard.

Federal officials are also hoping to ease administrative burdens by requiring health plans to use a single, uniform identifier for all their transactions. Both changes were addressed in a proposed rule released this spring.

Health and Human Services Secretary Kathleen Sebelius announced earlier this year that the health care community would get more time to get up to speed on ICD-10 (formally known as the International Classification of Diseases, 10th Revision), but the proposed rule firms up that commitment.

Many physician organizations, including the American Medical Association, complained to the HHS and members of Congress, arguing that the implementation of the ICD-10 codes will create a significant burden. And it would carry a hefty price tag – close to $100,000 for smaller practices and more than $2 million for large ones, according to the AMA.

Part of the problem, according to the HHS, is that medical practices are having trouble meeting the compliance deadline for a necessary prerequisite for ICD-10, the Associated Standard Committee’s X12 Version 5010 standards (Version 5010) for electronic health care transactions. Moving the compliance deadline for the so-called 5010 standard from October 2013 to October 2014 will give physicians more time to prepare and test their systems, the HHS wrote in its proposed rule.

The proposed rule also outlines a related measure: a plan to require health insurers to adopt a standard national unique health plan identifier, or HPID. Currently, health plans use multiple identifiers of differing lengths and formats. The vagaries of these identifiers can cause improper routing of transactions, difficulty in determining patient eligibility, and other claims processing errors. Health insurers must begin to use the standardized HPID by Oct. 1, 2012.

The use of a unique identifier will allow medical practices to make greater use of automation in claims processing, according to the proposed rule, in turn saving time and money. And, cleaner claims with fewer errors should compound the savings. HHS officials estimate that over 10 years, the return on investment for the entire health care industry will be between $700 million and $4.6 billion. The adoption of the unique health plan identifier is one of a series of regulations mandated by the Affordable Care Act and aimed at simplifying health care administrative transactions.

The federal government plans to delay for 1 year a requirement that doctors and other health care providers begin using the ICD-10 standard for diagnosis and procedure codes for 1 year. Physicians will now have until Oct. 1, 2014, to come into compliance with the standard.

Federal officials are also hoping to ease administrative burdens by requiring health plans to use a single, uniform identifier for all their transactions. Both changes were addressed in a proposed rule released this spring.

Health and Human Services Secretary Kathleen Sebelius announced earlier this year that the health care community would get more time to get up to speed on ICD-10 (formally known as the International Classification of Diseases, 10th Revision), but the proposed rule firms up that commitment.

Many physician organizations, including the American Medical Association, complained to the HHS and members of Congress, arguing that the implementation of the ICD-10 codes will create a significant burden. And it would carry a hefty price tag – close to $100,000 for smaller practices and more than $2 million for large ones, according to the AMA.

Part of the problem, according to the HHS, is that medical practices are having trouble meeting the compliance deadline for a necessary prerequisite for ICD-10, the Associated Standard Committee’s X12 Version 5010 standards (Version 5010) for electronic health care transactions. Moving the compliance deadline for the so-called 5010 standard from October 2013 to October 2014 will give physicians more time to prepare and test their systems, the HHS wrote in its proposed rule.

The proposed rule also outlines a related measure: a plan to require health insurers to adopt a standard national unique health plan identifier, or HPID. Currently, health plans use multiple identifiers of differing lengths and formats. The vagaries of these identifiers can cause improper routing of transactions, difficulty in determining patient eligibility, and other claims processing errors. Health insurers must begin to use the standardized HPID by Oct. 1, 2012.

The use of a unique identifier will allow medical practices to make greater use of automation in claims processing, according to the proposed rule, in turn saving time and money. And, cleaner claims with fewer errors should compound the savings. HHS officials estimate that over 10 years, the return on investment for the entire health care industry will be between $700 million and $4.6 billion. The adoption of the unique health plan identifier is one of a series of regulations mandated by the Affordable Care Act and aimed at simplifying health care administrative transactions.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

SAN FRANCISCO – The American Association for Thoracic Surgery (AATS) Council approved new lung cancer screening guidelines at this year’s AATS Annual Meeting. A summary of the new "Guidelines for Lung Cancer Screening using Low Dose Computed Tomography (LDCT) Scans for Lung Cancer Survivors and Other High Risk Groups: Report of the AATS Lung Cancer Screening and Surveillance Task Force," was presented by Dr. Michael T. Jaklitsch.

Dr. Jaklitisch, a thoracic surgeon at Brigham and Women’s Hospital and an associate professor of surgery at Harvard Medical School, Boston, is the co-chair of the AATS Lung Cancer Screening and Surveillance Task Force along with Dr. Francine Jacobson, assistant professor of radiology at the hospital.

The AATS established the Lung Cancer Screening and Surveillance Task Force (LCSSTF) to create these guidelines for both smokers at high risk for lung cancer and lung cancer survivors in response to the publication of the National Lung Screening Trial (NLST), a randomized phase III trial, published in August 2011. The trial provided level 1 evidence that low-dose chest CT screening reduced lung cancer specific mortality by 20%.

Other societies such as the American Lung Association have also responded to the NLST trial with similar recommendations.

"Roughly 7 million out of 94 million current and former smokers in the United States meet the NLST criteria for highest risk screening. More than 75% of the positive screening tests resulted in additional testing, most frequently by repeat imaging. Less than 10% of the tests required an invasive procedure for further work-up," according to the Task Force.

The Task Force reported that the radiation exposure from LDCT appears to be negligible. They cited the fact that the average effective dose per scan in the NLST trial was 1.5 mSv and that the American Association of Physicists in Medicine, in a position statement on radiation risks from medical imaging procedures in December 2011, stated: "Risks of medical imaging at effective doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable, and may be nonexistent."

The Task Force also recommends the provision of care by an interdisciplinary team of thoracic surgeons working with radiologists, pulmonologists and oncologists. Such a team is "required to ensure decreased mortality from lung cancer outside of strict clinical trials in academic centers, including 0.5% operative mortality, and appropriate minimally invasive capabilities such as VATS."

The Task Force also indicated that it is "most desirable to create a program for lung cancer screening that also supports smoking cessation." Throughout the process there should be data gathered to "allow study of outcomes that are important for the practice of evidence-based medicine in the era of personalized health care."

In a summary statement of their new guidelines, the AATS recommended lung cancer screening for 3 distinct groups:

1) Level 1 evidence in favor of screening currently exists for North Americans between the ages of 55 and 79 with a 30 pack-year smoking history.

2) Lung cancer survivors are an extremely high risk group for developing a second lung cancer, and should be screened with LDCT starting 5 years after treatment.

3) Younger patients (age 50) with a 20 pack-year smoking history should be screened if they have an additional risk factor that produces a 5% risk of developing a lung cancer over the next 5 years. "At our current state of knowledge, that includes patients with documented radon exposure, occupational exposure, a lung cancer history in a first-degree relative if that cancer was recognized at a young age, COPD with an FEV1 of greater than 70%, and a tissue diagnosis of pulmonary fibrosis," according to the Task Force.

As costs are always of concern in proposing any new screening program, the Task Force discussed a recent estimate of the cost and benefit of annual lung cancer screening offered as a commercial insurance benefit for high risk Americans aged 50-64 years. That estimate found a screening cost of $1 per insured member per month in 2012 dollars.

The cost per life-year saved would be below $19,000. This compares favorably to cost per life-year saved in breast ($31,000 to $52,000), colon ($19,000 to $29,000), and cervical cancers ($50,000 to $75,000), the Task Force added.

The Task Force worked through an interdisciplinary consensus process, and its members were selected for their leadership in lung cancer screening, diagnosis, treatment, and follow-up of patient who have nodules and lung cancer. The fourteen individual members of the LCSSTF comprised: an epidemiologist, a pulmonologist, a pathologist, three medical oncologists, four thoracic radiologists, and four thoracic surgeons.

The idea of establishing a Task Force to create these consensus guidelines for the AATS was conceived by Dr. David J. Sugarbaker, chief of the Division of Thoracic Surgery at Brigham and Women’s Hospital. Other AATS members included on the Task Force are Dr. Shaf Keshavjee, director of the Toronto Lung Transplant Program at the University of Toronto, and Dr. Scott Swanson, professor of surgery at Brigham and Women’s Hospital.

The members of the Task Force reported no relevant disclosures.

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan

The American Lung Association has also thrown its weight behind low-dose CT screening of heavy smokers who meet criteria set forth in the National Lung Screening Trial.

The group emphasized that it does not recommend universal screening at this time, and that it believes chest x-rays should not be used for lung cancer screening. It only recommends low-dose computed axial tomography screening – and only for current or past smokers aged 55-74 years, who have smoked at least 30 pack-years and have no history of lung cancer.

"For those who choose to undergo the screening process, smoking cessation should be continuously emphasized as it remains the best method of reducing lung cancer risk," according to an interim report outlining the new guidance.

The document comes from a seven-member Lung Cancer Screening Committee formed to assess the American Lung Association (ALA)’s position in light of the National Lung Screening Trial (NLST) results – the study was the first to show a screening program could reduce lung cancer deaths.

The panel’s charge was to review current evidence about lung cancer screening that would "offer the best possible guidance to the public and those suffering from lung disease."

The NLST randomized subjects at risk of lung cancer to three annual screenings with either low-dose CT or single-view posteroanterior chest x-rays. Investigators reported that low-dose CT was associated with a 20% decrease in mortality compared with chest x-rays. The false-positive rate reported in the publication of the trial results was 96% (N. Engl. J. Med. 2011;365:395-409).

Since the results were announced, the National Comprehensive Cancer Network (NCCN) has similarly endorsed screening of high-risk smokers, and the International Association for the Study of Lung Cancer (IASLC) has urged physicians to discuss screening with patients who smoke. Many other groups have yet to take a stand, however.

Although the landmark trial found solid evidence supporting annual screens in the population studied, the ALA noted it also raised many "personal and public health issues": among them, what to do about false positive results, the physical and emotional risks of screening and any resultant invasive procedures, cost implications, and equitable access to the CT procedure.

–Michele G. Sullivan