CMS to cover low-dose CT screening for lung cancer

Mount Sinai Health SystemNov 12 2014

The Centers for Medicare and Medicaid Services (CMS) today recognized the importance of lung cancer screening, announcing today that it will cover low-dose computed tomography (CT) screening, or "CAT" scans , for high-risk current and former smokers. The decision validates Mount Sinai's longstanding commitment to providing access to this essential screening tool.

The decision 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, the American College of Radiology (ACR) and The Society of Thoracic Surgeons and included nearly 100 other professional societies, public health organizations, medical centers and patient groups.

Lung cancer causes more deaths each year than colon, breast, and prostate cancers combined. It is the most lethal cancer killer for women and results in more than 155,000 deaths per year.. Early research studies led by Mount Sinai and the Early Lung Cancer Action Program (I-ELCAP) found CT screening to be effective in detecting lung cancer at its earliest, most curable stage. In addition, unequal access to health care services has contributed to disparities in lung cancer outcomes, with the highest number of deaths among African Americans.

Lung cancer accounts for more annual deaths than colon, breast, and prostate cancers combined. It is the most lethal cancer killer for women and results in over 155,000 deaths per year, accounting for 25 percent of all cancer deaths. Early research studies led by Mount Sinai and the Early Lung Cancer Action Program (I-ELCAP) found CT screening to be effective in detecting lung cancer at its earliest, most curable stage. In addition, unequal in access to health care services have contributed to disparities in lung cancer outcomes, with the highest number of deaths among African Americans.

"This announcement has been 20 years in the making," said Claudia Henschke, MD, head of I-ELCAP and Professor of Radiology at Icahn School of Medicine at Mount Sinai. "We know lung cancer screening saves lives and now it can be made available to older smokers who are at the highest risk of lung cancer. Thanks to the efforts of my colleagues and partners in this mission, this decision will lead to even more lives being saved."

Last December, the United States Preventive Services Task Force (USPSTF) recommended screening current and former heavy smokers ages 55 to 80 using CT. Mount Sinai championed this decision by sharing research screening data and opinions by its team of experts, and Drs. Henschke and Yankelevitz created the first screening protocol for performing low-dose CT scans and managing findings in the early 1990s.

"Researchers at Mount Sinai led the way with this issue and our voices have been heard," said David Yankelevitz, MD, Director, Lung Biopsy Service, The Mount Sinai Hospital. "The International Early Lung Cancer Action Program led by these researchers has screened over 66,000 patients, and has developed the largest web-based infrastructure for screening and reporting results. Our results show continued progress in finding cancers early and curing them."

Low-dose CT screening for lung cancer has historically been a controversial topic due to concerns regarding balance between the benefits and harms. This CMS decision now affirms the position that in high-risk populations with appropriate personnel and equipment, the benefits clearly outweigh the harms.

"At Mount Sinai, our lung cancer program is at the forefront of new breakthroughs in treatment of lung cancer but in order to save lives, we must find these cancers in their most early stages," said Raja Flores, MD, Chairman, Thoracic Surgery, The Mount Sinai Hospital. "This is only possible through screening."

"Disease curability involves detection at an early stage," said Charles Powell, MD, Professor of Medicine and CEO of the Mount Sinai - National Jewish Health Respiratory Institute of the Icahn School of Medicine at Mount Sinai. "Effective screening is more than a test, it is a process that begins with shared decision making to ensure that benefits are balanced by risks. The Mount Sinai program has a strong track record of lung cancer screening that brings together the best in imaging equipment, radiology interpretation, nodule evaluation, surgical treatment and registry development. These components result in a world-class program that maximizes the benefits and minimizes the harms of lung cancer screening. "