Medicare coverage for CT-lung screening in high-risk individuals

By ACSH Staff — Sep 22, 2014
Lung cancer kills about 435 people in the United States every day, making it the leading cancer killer of both American men and women.

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Lung cancer kills about 435 people in the United States every day, making it the leading cancer killer of both American men and women. In 2014 alone, it is expected that lung cancer will claim the lives of 160,000 Americans. And unlike that several other cancers, the prognosis for lung cancer remains desperately grim, with a 5-year survival rate of about 15 percent. Despite the debate about the effectiveness of cancer treatments and screening programs, there is increasing evidence that CT screening for lung cancer can save lives, say Drs. Andrea McKee, chairwoman of the department of radiation oncology at Lahey Hospital and Medical Center and Andrew Salner, radiation oncology chief at Hartford Hospital, in their op-ed in the New York Times entitled, A Cancer Battle We Can Win.

They reference the recently published study called the National Lung Screening Trial (NLST), in which the authors reported that NLST patients aged 65 years and older had a higher cancer prevalence and their scans had greater positive predictive value (PPV) than those of younger patients. They also point out that medical organizations including the United States Preventive Services Task Force recommend CT lung screening for high-risk individuals. This group includes about nine million Americans and is defined as adults ages 55 to 80 years old who have a 30 year history of smoking (a pack a day or more).

Currently, Medicare does not currently cover CT screening for high-risk individuals, but by November, a decision will be made regarding coverage for Medicare beneficiaries. Drs. McKee and Salner conclude, We can achieve a solid win against cancer. CT lung screening for high-risk populations, with high quality standards is ready for prime time. The government should move quickly to cover this life-saving intervention for Medicare users.

ACSH s Dr. Gil Ross added this comment: We here at ACSH have become progressively less sanguine about the ostensible benefits of cancer screening s pros and cons, in general. We have disputed the logic of annual mammograms for women starting at age 40 and going until senescence, as well as similar approaches for prostate cancer with PSA testing. In contrast, screening colonoscopy has proven effective for reducing the toll of colorectal cancer. And we believe the evidence clearly shows a potential for saving many lives from the terrible toll of lung cancer thanks to cigarette smoking, via the increased coverage and use of spiral, low-dose CT scans for high-risk patients, and we hope that those governing Medicare will agree.

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