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TIDBSI: Low-Dose CT Screening

Justin McCarthy, MD and Paul Simmons, MD
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No me gusta!

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Screening for lung cancer is a controversial topic among medical professionals and patients. In this segment, our intrepid Things I Do But Should I duo Paul and Justin dig deep into the guidelines so we can guide our patients through this decision.

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Ian L., Dr -

Serial PET scan can be done to stratify nodules .People who stopped smoking after 20 years or more deserve ought be paid to have screening
Also you could screen more selectivity reducing the number you think of screening to one million .
The technology ought improve over the next years .

Paul S., MD -

Hi, everyone! Justin and I just wanted to update you all: The USPSTF is updating their LDCT screening recommendations (despite our skepticism!) by LOWERING the starting age to 50 years of age, and the pack-year requirement to 20 pack-years. You can read the draft recommendation at the link below -

Link: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/lung-cancer-screening-2020

Thanks!
Paul

Kimberly B. -

Thank you for doing this piece! I definitely feel on the fence about this screening and so far I have mostly ordered it on patients who came in asking for it. Interestingly, my employer is pushing it and anti-pushing it at the same time. I get regular emails reminding me to order it on my patients but I’m not allowed to order it without completing a paper form plus a form on the computer documenting that I’ve counseled my patient about false positives and also that the patient has agreed to come back every year for another CT. When I order a mammogram, my patient doesn’t have to sign a form that she agrees to get a mammogram every year. Is this a CMS rule or a Jahco rule or what is going on?

Neda F., MD -

Hi Kimberly! We all enjoyed your question. :) Paul, Justin, and I have not had to face those restrictions in our own practices. None of us knows or believes there to be any kind of national checklists before you can order the CT. Wishing you luck - Neda

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Primary Care RAP October 2020 Written Summary 310 KB - PDF

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