The American Society for Radiation Oncology (ASTRO) has issued a statement objecting to the Medicare Evidence Development and Coverage Advisory Committee’s (MEDCAC) April 30, 2014 recommendation that the Centers for Medicare and Medicaid Services (CMS) not provide coverage for annual, low-dose computed tomography (LDCT) screenings for adults at high risk of lung cancer.
The MEDCAC recommendation flies in the face of a December 2013 United States Preventive* Services Task Force (USPSTF) recommendation that scored LDCT as a grade B screening procedure. ASTRO has urged CMS to support the USPSTF proposal over the MEDCAC finding. Under the federal Patient Protection and Affordable Care Act (PPACA), private health care insurers must provide coverage without a copay for all exams or procedures graded “B” or higher by the USPSTF. The law’s provisions do not require Medicare to follow the USPSTF’s recommendations for its beneficiaries.
The USPSTF statement recommended annual screenings for adults 55 to 80 years old with a 30 pack-year smoking history who currently smoke or have quit within the past 15 years. Screening is discouraged once a patient has not smoked for 15 years or develops health conditions that limit life expectancy or the ability or willingness to undergo lung surgery. The recommendation was based on analysis of results from four randomized clinical trials, which found a 16% reduction in lung cancer deaths among patients who fit the above criteria and received annual screening.
“Lung cancer is the leading cause of cancer death for both men and women in the United States, surpassing the number of deaths from breast, colon and prostate cancers combined. Research demonstrates that screening current and former heavy smokers with low-dose CT scans can reduce lung cancer mortality by nearly 20% in high-risk individuals,” said ASTRO chair Colleen A.F. Lawton, MD. “Regular screening for those at highest risk for lung cancer has the potential for earlier diagnosis—when treatment can be most successful and save lives. ASTRO strongly encourages CMS to provide coverage to Medicare beneficiaries for this life-saving screening.”
For more information, visit ASTRO.