publication date: Mar. 21, 2014


The Centers for Medicare and Medicaid Services is facing the formidable challenge of deciding what kinds of patients should be screened for lung cancer.

The agency’s Medicare Evidence Development & Coverage Advisory Committee will meet April 30 to decide how the positive findings of a large randomized trial and the recommendation the U.S. Preventive Services Task Force should be translated into policy.

The controversy over screening for lung cancer will demonstrate how scientific findings influence the standard of care in the new healthcare system. Under the Affordable Care Act, USPSTF grades translate into coverage mandates for private insurers.

The U.S. healthcare system has historically encouraged rapid implementation of screening technologies. The government has been limited in its ability to put brakes on implementation of unproven screening technologies, and in situations where screening has been found to be not beneficial—or even harmful—doctors and the public resist efforts to limit access.

Now, Obamacare is lowering the barriers for coverage, but its ability to resist pressure from subspecialties and advocacy groups intent on broadening screening mandates remains untested.

The CMS advisory committee will have to decide which risk groups should be eligible for screening and whether data would continue to be collected after coverage is extended:

• Under one scenario, coverage could be extended only to individuals whose age and smoking history mimic those of participants of the National Lung Screening Trial, which found a reduction in long cancer mortality in the screened population. … Continue reading 40-12 Cancer Screening

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