USPSTF lung cancer screening recommendations in high-risk Medicare beneficiaries is cost effective

United States Preventive Services Task ForceSep 3 2014

Questions regarding effectiveness, infrastructure and cost effectiveness of low-dose computed tomography (CT) screening of those at high risk for lung cancer have now been answered. Medicare should rapidly provide full national coverage for these exams.

An actuarial cost-benefit analysis by Milliman, Inc., published in the August issue of American Health and Drug Benefits, shows that use of United States Preventive Services Task Force (USPSTF) lung cancer screening recommendations in high-risk Medicare beneficiaries is cost effective.

• This latest Milliman analysis echoes a 2012 study published in Health Affairs that found low-dose CT lung cancer screening is cost effective in high-risk commercially-insured people.

• National Lung Screening Trial data presented to the National Institutes of Health confirmed that the test is cost effective — particularly compared to other screening programs.

• Other published data show that the test is more cost effective than automobile seatbelts/airbags.

"CT lung cancer screening is cost-effective and significantly reduces lung cancer deaths. Published results show no undue or lasting patient anxiety from the screening process. It is time for Medicare to cover CT lung cancer screening," said Ella Kazerooni, M.D., FACR, chair of the American College of Radiology (ACR) Lung Cancer Screening Committee and ACR Thoracic Imaging Panel.

Significant lung cancer screening infrastructure is growing. The ACR Lung Cancer Screening Center program helps ensure these exams are provided safely and effectively. Lung-RADS standardizes CT lung cancer screening reporting and management, aids lung CT interpretation and supports outcomes monitoring.

The Affordable Care Act requires private insurers to cover medical procedures that receive a grade of "B" or higher from the USPSTF without a co-pay. The ACA does not specify that Medicare beneficiaries receive full coverage for these services. CT lung cancer screening is deemed an Essential Health Benefit, covered by many private health insurers, while Medicare beneficiaries have lesser access to these exams and increased risk of lung cancer death due to lack of coverage.

"Lung cancer is the nation's leading cancer killer, annually taking more lives than breast, prostate and colon cancer combined. CT lung cancer screening could save up to 30,000 people each year. Medicare needs to help doctors save lives by fully covering these exams," said Kazerooni.