Should tobacco companies pay for smokers’ CT scans to screen for lung cancer?

According to a potential ruling in Massachusetts, tobacco companies will have to pay for smokers’ screening CT scans.

The Boston Globe (via Doug Farrago) writes that the decision “would allow thousands of other Massachusetts smokers to join the lawsuit, which covers people 50 or older who have smoked at least one pack a day of Marlboro cigarettes for at least 20 years,” and, “if a jury sides with the smokers, Philip Morris could be required to pay for each patient’s low-dose computed tomography scan, which can detect early-stage lung cancer.”

Now, I’m all for penalizing tobacco companies, but there some unintended consequences here.

First, there is no evidence that CT scans for early detection of lung cancer saves lives. In fact, the USPSTF doesn’t recommend it.

Second, what happens if the CT scan detects all sorts incidental findings, like benign masses that necessitate further workup? Indeed, a lung biopsy may be needed to definitively exclude cancer, which itself can lead to bleeding, infection, or other complications.

Would the tobacco companies pay for the additional tests that stem from the screening CT scan? If not, this decision will only further fiscally burden our health system.

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