Radiologists and thoracic surgeons are uniting to voice shared concerns over federal efforts to expand lung cancer screening eligibility.
The Centers for Medicare & Medicaid Services announced in November that it believes the evidence is sufficient to broaden payment for such low-dose CT imaging exams. Its proposal would include dropping the starting age from 55 down to 50 while also lowering how much one has to smoke to qualify, as recently recommended by industry experts.
However, the American College of Radiology and Society of Thoracic Surgeons want the agency to go further. In comments submitted Thursday, the two groups urged the agency to also remove two recommended screening cutoffs—after age 77 and if an individual stopped smoking more than 15 years ago.
“We strongly urge CMS to delete the 15-year smoking quit date screening eligibility criterion, as there is no substantive data to support a significant reduction in lung cancer risk at that time frame,” ACR, the thoracic surgery society, and the GO2 Foundation for Lung Cancer wrote to the agency on Dec. 16.
In addition, the groups want CMS to maintain criteria dictating imaging facility’s eligibility to receive Medicare reimbursement for lung cancer screening. While removing this provision may expand access, they said, it would eliminate important safeguards that prevent seniors from harm.
The agency also wants to require that patients receive counseling and collaborate with clinicians on decision making, but ACR et al. see this as a potential hindrance.
“Our joint societies fully support the importance of [shared decision making] and the provider/patient conversation as a valuable part of all cancer screenings and other tests,” they wrote. “However, the added burden of medical record documentation should not be a requirement for lung cancer screening by tying it to coverage and reimbursement.”
ACR highlighted its concerns in a new update posted on Friday. The Centers for Medicare & Medicaid Services has said it hopes to finalize the National Coverage Determination process by Feb. 15.
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.