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Opinion EDITORIAL LESS IS MORE Tanner Caverly, MD, MPH The Center for Medicare and Medicaid Services (CMS) re- equal), the lower the likelihood that screening will be ben- cently decided to reimburse for annual lung cancer screening eficial. Age alone is not a strong predictor of surgical risk. with low-dose computed tomography (LDCT) among per- Underlying comorbidities, such as heart failure or severe sons who meet the inclusion criteria for the National Lung Can- chronic obstructive pulmonary disease, and functional sta- 1 7 cer Screening Trial (NLST). tus are much more important. The presence of multiple Those who have smoked for risk factors can result in very high risk for death related to Related article page 896 more than 30 pack-years, con- surgery. A model developed to predict in-hospital death fol- 8,9 tinue to smoke, or quit within lowing thoracic surgery suggests that the risk of death in the past 15 years and are 55 to 77 years old will be eligible for a healthy man older than 65 years undergoing an elective free annual LDCT screening—roughly 6% of the US popula- lobectomy for lung cancer is about 1%, which is similar to 2 10 tion older than 40
JAMA Internal Medicine – American Medical Association
Published: Jun 1, 2015
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