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Issue Date: March 2013


Best Doctors 2013: Screen Saver


Lynne Thompson

University Hospitals has eliminated a major barrier to screening for America's most deadly cancer: cost. Dr. Robert "Chip" Gilkeson, vice chairman of research in UH's department of radiology created a program that provides $99 CT scans to those at risk for lung cancer. The expense is a fraction of the test's traditional cost and the hospital system is one of the first places in the nation to offer the low-cost screening.

The effort was spurred by a National Institutes of Health study published in the August 2011 The New England Journal of Medicine that showed CT scans detect tumors early enough to reduce the risk of dying from lung cancer as much as 20 percent in middle-age and elderly smokers. Though most major physician and patient-advocacy groups support the scan, Gilkeson says many insurance plans won't cover it.

"There's always a significant lag time before insurers, whether it be Medicare or private insurers, decide something is really worth the cost," he says.

The $99 CT scan is available to those ages 55 to 74 who have smoked at least 30 "pack years" — defined as smoking at least a pack of cigarettes a day for 30 years, or two packs a day for 15 years. Those who quit fewer than 15 years ago are also eligible for the discount with a physician referral.

Gilkeson says the screening usually costs anywhere from $300 to $1,000. The nonprofit hospital system absorbs the difference in cost as it does in providing other community programs.

"People say, •Are you crazy? Why are you doing this?' " Gilkeson says. "Ultimately, it's to improve the health of the patients."


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