Milestones in lung cancer research and policy
On August 16, The U.S. Preventive Services Task Force (USPSTF), an independent body established by the government to evaluate preventive services, releases its Final Research Plan for the update to its lung cancer screening recommendation. This is an essential preliminary step for their next final screening report which is expected to be published by the end of 2019 or sometime 2020.
- The USPSTF’s current recommendations, published in December 2013, support the use of lung cancer screening with LDCT as a preventive health service for the high-risk population for ages 55-80 years.
On May 3, the U.S. Preventive Services Task Force (USPSTF) posts their Draft Research Plan for their five-year cycle review of the lung cancer screening recommendation slated for 2020.
- Lung Cancer Alliance (LCA) reignited coalition efforts through a partnership with the Society of Thoracic Surgeons (STS) and American College of Radiology (ACR). The coalition submitted recommendations to United States Preventive Services Task Force (USPSTF) in an effort to shape the next round of USPSTF review for lung cancer screening. The coalition letter encourages USPSTF to evaluate screening from objective information reflecting current studies and real-world implementation experience for the benefit of those at high risk.
On February 5, Centers for Medicare and Medicaid Services (CMS) announces coverage without co-pays or deductibles for those age 65-77 at high risk, effective immediately. This marks the day that nearly 10 million Americans have access to low dose CT lung cancer screening like any other essential health benefit. All Medicare beneficiaries eligible have coverage for screening nationwide and prevention and early detection in place.
CMS launches evidence review and convenes a MedCAC hearing on April 30 where LCA presents and advocates for lung cancer screening. CMS later posts a proposed coverage decision for lung cancer screening on November 10 and LCA submits formal comments in collaboration with key stakeholders and the Lung Cancer Coalition.
LCA initiates the request to CMS on October 25 to open a National Coverage Analysis and determine national screening coverage for the Medicare population.
Milliman Inc., a leading international actuarial firm, continues its series of mortality and payer cost analytics indicating that CT lung cancer screening of a targeted high-risk population would save thousands of lives a year and that coverage of this preventive benefit under commercial insurance and Medicare is cost-effective.
On December 31, the U.S. Preventive Services Task Force (USPSTF) completes their evidence review and gives a “B” recommendation to CT screening for a targeted lung cancer high risk population ages 55-80 which, under the Affordable Care Act, must be covered for those eligible without co-pays or deductibles by commercial insurers (with certain exceptions) for those under 65, effective at plan renewal dates in 2015.
LCA initiates the National Framework for Lung Cancer Screening Excellence to promote quality standards in screening sites and public awareness. Screening Centers of Excellence network launched to support centers with responsible, high-quality screening practices.
New England Journal of Medicine publishes results of National Lung Screening Trial which concludes: “Screening with the use of low-dose CT reduces mortality from lung cancer.i”
National Lung Screening Trial halted when CT arm reached the endpoint. X-ray arm participants advised of CT superior results.
New England Journal of Medicine publishes results of I-ELCAP observational studies which concludes: “Annual spiral CT screening can detect lung cancer that is curable.ii”
National Cancer Institute (NCI) launches the National Lung Screening Trial, 55,000 person randomized controlled trial comparing CT scans to x-rays in diagnosing lung cancer and reducing its mortality rate. Trial designed to end when one arm reaches a 20% reduction.
Early Lung Cancer Action Program initiates research on CT screening for lung cancer.
[i]N Engl J Med 2011;365:395-409
[ii]N Engl J Med 2006;355:1763-71