In a major step forward for lung health and diagnostic screening, on November 10th, 2014 The Centers for Medicare & Medicaid Services (CMS) proposed that the evidence is sufficient to add coverage for lung cancer screening counseling and a shared decision making visit, and a screening for lung cancer with low dose computed tomography (LDCT) once per year for qualified beneficiaries. Of course, the coverage is seen as an additional preventive service benefit under the Medicare program, and is available only if certain criteria are met.
The CMS has been under mounting pressure from the National Cancer Institute and various organizations to add CT lung cancer screening to their benefits program, since a National Lung Screening Trial found that patients who received low-dose helical CT scans had a 15 to 20% lower risk of dying from lung cancer than participants who received standard chest X-rays.
“CT lung cancer screening is the first and only cost-effective test proven to significantly reduce lung cancer deaths. Medicare coverage provides access to care for seniors and will help physicians save thousands of lives each year from the nation’s leading cancer killer,” Ella Kazerooni, MD, FACR, chair of the American College of Radiology Lung Cancer Screening Committee and American College of Radiology Thoracic Imaging Panel, said in a release.
– Age 55-74 years
– Asymptomatic (no signs or symptoms of lung disease)
– Tobacco smoking history of at least 30 pack-a day years
– Current smoker or one who has quit smoking within the last 15 years
– A written order for LDCT lung cancer screening from a physician (must meet certain additional criteria)
This is just a small victory in lung cancer screening. Small-cell lung cancers, which are very aggressive, were infrequently detected at early stages by low-dose helical CT or chest X-ray. As technology advances, we only hope that we will be able to detect these cancers. The trouble is making the new technology available to those that need it. Few people can afford to purchase coverage on their own without financial assistance. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. Medicaid provides health coverage to more than 4.6 million low-income seniors, nearly all of whom are also enrolled in Medicare.
“Lung cancer will kill 160,000 Americans this year – more than breast, colon and prostate cancers combined. Medicare coverage of these exams helps complete the first major blow against this terrible disease. This is a great day for those at high-risk for lung cancer and their families. We look forward to a future where a lung cancer diagnosis is no longer essentially a death sentence for so many people,” Kazerooni said in the release.
Read More: 9 million US Smokers Should Get a Yearly Lung Screening