On Nov. 10, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a draft decision memo that would require Medicare to cover the cost of low-dose computed tomography (CT) lung cancer screening for high-risk Medicare beneficiaries between the ages of 55 and 74.
The CMS decision means that approximately four million Medicare beneficiaries who fit the eligibility criteria for screening will now be covered. It is largely aligned with the recommendations submitted to CMS in September by a coalition led by Lung Cancer Alliance (LCA), the nation’s first and leading lung cancer patient advocacy organization; American College of Radiology (ACR); Society of Thoracic Surgeons, and nearly 100 other professional societies, public health organizations, medical centers and patient groups.
High-risk patients who will benefit from a lung cancer screening include those who:
- Are between the ages of 55 and 74, and who are current or former smokers with at least a 30 pack year smoking history. A “pack year” is the number of packs smoked daily multiplied by the number of years smoking; therefore, an eligible person could have smoked one pack a day for 30 years; or two packs a day for 15 years, etc.).
- Are former smokers who have quit within the last 15 years.
- Are currently in fairly good health (as determined by discussion between you and a qualified healthcare professional).
Cassling, a sales and service dealer for Siemens Healthcare, has seen increased demand for CT units from hospitals and clinics throughout the Midwest. In Nebraska, Cassling has installed 25 new CT scanners in just the past five years. According to Mike Cassling, president and CEO of Cassling, the CMS draft decision couldn’t have come at a better time. “Nearly 1,200 Nebraskans and 2,400 Iowans will develop new cases of lung cancer this year,” Cassling said. “What’s worse, typically 75 percent of those who are diagnosed die from the disease because it isn't detected until it has reached an advanced stage.”
That’s because most people who develop lung cancer initially lack symptoms that warrant medical attention. Symptoms such as persistent cough, chest pain, shortness of breath or recurring infections often don’t begin to appear until the disease has progressed—which makes CT screening worthwhile, especially in high-risk cases.
Except for the final ruling, the CMS draft decision is the last major piece in a long series of validations reaffirming the lifesaving benefits of lung cancer screening. Lung cancer screening was scientifically proven in 2011 by one of the largest randomized controlled trials in the history of the National Cancer Institute (NCI). NCI’s National Lung Screening Trial (NLST) confirmed that screening can reduce overall death from lung cancer by at least 20 percent.
