Women screened for breast cancer are dying from lung cancer: An opportunity to improve lung cancer screening in a mammography population.

OBJECTIVE: Lung cancer is the leading cancer killer in women, resulting in more deaths than breast, cervical and ovarian cancer combined. Screening for lung cancer has been shown to significantly reduce mortality, with some evidence that women may have a greater benefit. This study demonstrates that a population of women being screened for breast cancer may greatly benefit from screening for lung cancer. METHODS: Data from 18,040 women who were screened for breast cancer in 2015 at two imaging facilities that also performed lung screening were reviewed. A natural language-processing algorithm followed by a manual chart review identified women eligible for lung cancer screening by U.S. Preventive Services Task Force (USPSTF) criteria. A chart review of these eligible women was performed to determine subsequent enrollment in a lung screening program (2016-2019), current screening eligibility, cancer diagnoses and cancer-related outcomes. RESULTS: Natural language processing identified 685 women undergoing screening mammography who were also potentially eligible for lung screening based on age and smoking history. Manual chart review confirmed 251 were eligible under USPSTF criteria. By June 2019, 63 (25%) had enrolled in lung screening, of which three were diagnosed with screening-detected lung cancer resulting in zero deaths. Of 188 not screened, seven were diagnosed with lung cancer resulting in five deaths by study end. Four women received a diagnosis of breast cancer with no deaths. CONCLUSION: Women screened for breast cancer are dying from lung cancer. We must capitalize on reducing barriers to improve screening for lung cancer among high-risk women.

Patient perception of Medicare reimbursement to orthopedic surgeons for THA and TKA.

A survey study was performed of individuals in an orthopedic clinic waiting room regarding their knowledge of Medicare reimbursement to orthopedic surgeons for primary THA and TKA. A total of 1200 surveys were submitted by individuals (median age 64 years, 61% female, 50% with Medicare as their primary insurance and 29% having had THA or TKA). The median amount respondents felt that a reasonable fee to the orthopedic surgeon for performing THA or TKA was $5000, while they estimated the Medicare reimbursement to be much less. When asked what was the most they would be willing to pay out-of-pocket to have the surgery performed or for advanced technology related to the procedure, the median was $2000. Most respondents were willing to wait 3-7 weeks for surgery to be performed. Participants tended to value THA and TKA more relative to Medicare payments and tended to overestimate Medicare reimbursement to surgeons for THA and TKA.