Congress supports full Medicare coverage of lung cancer screening for seniors

A large number of United States Senators and Representatives are taking the lead to support full Medicare coverage of low-dose computed tomography (LDCT) screening for seniors at high risk for lung cancer.

Through grassroots advocacy from The Society of Thoracic Surgeons (STS), the American College of Radiology (ACR), and the Lung Cancer Alliance (LCA), among others, members of the House (today) and Senate (last week) sent letters to the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) urging full Medicare coverage of these lifesaving exams in the target population.

Lung cancer kills more people than the next three cancers combined (breast, colon, prostate), yet is the only one of these cancers without Medicare coverage for screening to detect early stage disease. Data now show a 20% mortality reduction in high-risk patients being screened for lung cancer using LDCT.

Spearheaded by Senators Dianne Feinstein (D-Calif.) and Johnny Isakson (R-Ga.), the Senate letter had 45 signatories; the House letter, authored by Representatives Charles Boustany Jr., MD (R-La. and cardiothoracic surgeon), John Barrow (D-Ga.), Jim Renacci (R-Ohio), and Richard E. Neal (D-Mass.), had 134 total signatories.

"This effort by Congress is an important step toward ensuring that patients at greatest risk for lung cancer can be diagnosed and treated in the early stages when they have a better chance of survival," said Douglas E. Wood, MD, STS Immediate Past President. "About 160,000 patients in the US die of lung cancer each year. We have the ability—and the responsibility—to help these individuals at a point when the cancer is still curable."

Last December, the United States Preventive Services Task Force (USPSTF) recommended lung cancer screening for high-risk patients. Under the Affordable Care Act, private insurers are required to begin covering this service starting January 1, 2015. Paradoxically, Medicare is not required to follow USPSTF recommendations. CMS will make its final coverage decision in November.

The median age for lung cancer diagnosis is 70, meaning that if Medicare does not cover lung cancer screening for high-risk patients, the population that could benefit most from screening won't have access to it.

"We are now starting to screen those at high risk under the age of 65," said Laurie Fenton Ambrose, LCA President & CEO. "A person's risk for lung cancer does not magically disappear when they reach that age. Therefore it is neither logical nor ethical to stop screening at that point. We shouldn't have a patchwork system that provides access to some and then not others at high risk."

Screening advocates want CMS to follow the USPSTF recommendations and provide full national coverage of LDCT lung cancer screening for the USPSTF-defined population.

"For the first time, we have the ability to save thousands of people each year from the nation's leading cancer killer. The USPSTF has recommended coverage of low-dose CT lung cancer screening. Screening infrastructure is emerging and the privately insured already have coverage. It is time for Medicare to fully cover beneficiaries for these lifesaving exams," said Bibb Allen, MD, chair of the ACR Board of Chancellors.

Cardiothoracic surgeons, radiologists, and lung cancer screening advocates have been meeting with government officials to both emphasize the importance of Medicare coverage and provide guidance on the safe and effective implementation of a lung cancer screening program using tools and guidelines the organizations have already developed.