Lung cancer screening: What this means for smokers

Berlin. Long-term, heavy smokers will soon be able to take advantage of a free annual screening for lung cancer. The Federal Joint Committee (GBA) decided on Wednesday that the low-dose computed tomography (CT) examination will be covered by health insurance in the future, a spokesperson confirmed in response to a dpa inquiry. The examination can be performed every twelve months.

The program is aimed at heavy smokers between the ages of 50 and 75. It only applies to cigarettes, not other tobacco products. Individuals must have smoked continuously for at least 25 years and have at least 15 pack-years of smoking experience. Pack-years are calculated by multiplying the number of packs of cigarettes smoked per day by the number of years they have smoked.

"Ex-smokers can also participate in the studies, provided they have not been abstinent for more than ten years," explains Stefan Sauerland of the Institute for Quality and Efficiency in Health Care (IQWiG). The IQWiG provides detailed information on its website .

"There are an estimated 2 million people in Germany who meet these criteria," says Sauerland. Until now, smokers could only undergo a CT scan if they had symptoms, such as coughing up blood.

The earlier cancer is detected, the higher the chances of a cure and the lower the death rate. According to the German Cancer Research Center (DKFZ), low-dose CT can detect lung cancer with a high degree of certainty, before symptoms appear.

"We know from studies that early detection could prevent 20 percent of cancer deaths in this target group," says Sauerland. If everyone went for early detection, the doctor says, up to 1,000 cancer deaths could be prevented in Germany each year.

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Without early detection, according to the university professor, lung cancer is only diagnosed at an advanced stage in three-quarters of cases. The prognosis is then generally poor. "Around 80 percent of these people die within the following five years."

As with any X-ray examination, CT scans involve radiation exposure, which can potentially contribute to the development of cancer. The Federal Office for Radiation Protection estimates that fewer than 3 in 1,000 women and approximately 1 in 1,000 men will develop cancer within 25 years. However, this is acceptable relative to the normal cancer incidence, says Sauerland.

It's also possible that false-positive results occur, and suspicious changes ultimately turn out to be benign. Patients may then have to undergo further testing, such as a biopsy, even though it wasn't necessary.

Overall, the benefits outweigh the risks for the target group, according to the assessment of the Federal Office for Radiation Protection. However, stringent quality management for the entire early detection process and regular evaluation of the measure are "essential."

This could take several more months. The GBA estimates that this will likely be ready by April 2026. Following the GBA's decision, the Federal Ministry of Health must first provide feedback. If there are no objections, physicians and health insurance companies must agree on a reimbursement plan. They have up to six months to do so. Only then can practicing physicians bill statutory health insurance companies for the new service.

In theory, those affected have been able to undergo CT scanning since July 2024 – but initially at their own expense. At that time, the regulation of the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection, which forms the basis for the GBA decision, came into force.

The Federal Joint Committee is the highest decision-making body of self-governing health care in Germany. It issues guidelines that determine which medical services the approximately 74 million members of statutory health insurance are entitled to.

According to the German Cancer Research Center (DKFZ), approximately 56,500 people in Germany develop lung cancer each year. Lung cancer is the most common cause of cancer death among men, with approximately 28,000 deaths per year. Among women, it is the second most common, with 17,000 deaths.

In Germany, nine out of ten lung cancer cases in men and at least six out of ten in women are probably due to active smoking.

RND/dpa