CMS Wants To Cover Yearly Lung Cancer Tests for High-Risk People
CMS on Monday in a draft decision proposed covering annual low-dose CT scans for lung cancer screening for Medicare beneficiaries ages 55 to 74 who have a history of heavy smoking, the New York Times reports.
According to the Times, about 160,000 U.S. residents die from lung cancer annually, with nearly 90% of diagnosed individuals dying from the disease, in part because of late detection.
In 2010, a large clinical trial found that patients at high risk of lung cancer who underwent CT scans had about a 16% lower risk of dying from lung cancer compared with patients who underwent chest X-rays (Tavernise, New York Times, 11/10).
Meanwhile, the United States Preventive Services Task Force in earlier this year recommended the tests by giving CT scans for heavy smokers between ages 55 to 80 a "B" grade.
However, a CMS panel of expert advisers in April cautioned the agency against widespread use of annual CT scans (CMS proposed decision memo, 11/10).
Details of Proposed Decision Memo
Under the draft proposal, the scans would be available to beneficiaries who:
- Are asymptomatic (Kelly, Reuters, 11/10);
- Are current smokers or quit within the past 15 years; and
- Smoked one or more packs daily for 30 years or an equivalent amount (New York Times, 11/10).
Following stakeholder concerns, CMS proposed specific eligibility criteria for radiologists and radiology imaging centers, including that:
- Radiologists be certified with the American Board of Radiology or an equivalent organization and have received documented training in radiation safety and diagnostic radiology; and
- Radiology imaging centers submit data to a CMS-approved national registry for every low-dose CT scan they perform "to confirm patient screening selection, radiation dose, standard nodule reporting and test positivity, [and] follow-up diagnostic testing" (CMS proposed decision memo, 11/10).
CMS wrote, "We believe the proposed decision strikes an appropriate balance between providing access to this service and ensuring, to the best extent possible, that the benefits outweigh the harms when implemented in the Medicare population" (Young, CQ HealthBeat, 11/10).
CMS will receive public comments on the proposal for 30 days and will not release a finalized decision until February 2015. However, such decisions are almost never reversed, and stakeholders said they did not anticipate major changes as the process goes forward, according to the Times.
Lung Cancer Alliance President Laurie Fenton Ambrose in a release said that the CMS proposal "is important validation, and it ends the debate," adding, "Screening saves lives. The public needs to know that" (New York Times, 11/10).
Meanwhile, the American Lung Association also touted the recommendations in a statement, noting that the screenings could improve survival rates (Reuters, 11/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.