CDC: States falling woefully short on low-dose CT cancer screening goals; ACR pushes pay fix
States are falling woefully short of meeting goals to provide low-dose CT screenings to patients at a high risk of lung cancer, according to a new report released Thursday. And the American College of Radiology is currently working to eliminate one huge impediment.
Quizzing tens of thousands of Americans over the phone, the Centers for Disease Control and Prevention found that more than 87% of those recommended for such scans never received them. This is despite recent evidence that former and current smokers who take park in annual imaging check-ins can reduce their risk of death from lung cancer by 25%.
“These findings suggest an opportunity to educate both patients and healthcare providers, provide decision support tools to reinforce appropriate screening triage, and apply evidence-based interventions,” the CDC wrote in its latest Morbidity and Mortality Weekly Report.
The CDC gathered its findings as part of a random phone survey of U.S. adults in 10 states, conducted in 2017. This was the first year that the centers added additional questions on lung cancer screening as part of its Behavioral Risk Factor Surveillance System.
All told, states administered the survey to more than 85,000 respondents. About 12.7% met U.S. Preventive Services Task Force’s recommendations for annual low-dose CT. That includes being between the ages of 55-80, having a greater than 30-pack-per-year smoking history, and either continuing the habit or having quit within the last 15 years. Out of those eligible, just 12.5% said they had actually received a low-dose CT scan to screen for lung cancer in the last 12 months.
CDC officials urged states and providers to use this data to help evaluate where further screening is needed, and pinpoint barriers. The American College of Radiology believes tens of thousands of lives could be saved annually in the U.S. if this practice became widespread, but “drastically low” Medicare rates remain a significant impediment.
Last month, the ACR estimated that payment for these “vital exams” is as low as $60 apiece in the hospital outpatient setting. However, in comments submitted to the Centers for Medicare & Medicaid Services on Feb. 26, the ACR is suggesting a $233.01 reimbursement rate in 2021 for screening without contrast material.
“ACR has been committed to improving access to low-dose CT lung cancer screening to Medicare beneficiaries,” wrote Norman Thomson III, MD, a Georgia radiologist who chairs ACR’s committee on the Hospital Outpatient Prospective Payment System. “More than 200,000 people in the United States will be diagnosed with lung cancer this year and nearly 142,000 will die of the disease. The life-saving benefits of LDCT screening in at-risk populations are documented; in fact, 20-30% more lives could be saved if high-risk patients were referred for regular screening.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.