Medicare Coverage for Lung Cancer Screenings?

The Lung Cancer Action Network (LungCAN), an association of 501(c)(3) nonprofits in the United States dedicated to serving the lung cancer community, urges you to stand in solidarity with us in support of Medicare coverage for seniors at high risk for lung cancer, as identified by the U.S. Preventive Services Task Force (USPSTF).1

The Center for Medicare and Medicaid Services (CMS) is now considering whether Medicare should cover lung cancer screening for seniors at high risk for the disease. Astonishingly, rejecting scientific evidence that lung cancer screening saves lives, the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) recommended against Medicare covering the cost of this procedure. The panel, however, did not include members who specialize in lung cancer. In fact, one panel member even publicly    opposed    USPSTF    screening    recommendations.    The    advisory    panel’s recommendation against Medicare coverage for lung cancer screening dismayed and disappointed many.

Lung cancer—the #1 cancer killer—kills more Americans than breast, colon, prostate and pancreatic cancers combined. Most lung cancer diagnoses are not discovered until the disease is advanced. Therefore, the majority of lung cancer patients die within a year of their diagnosis.

Lung cancer screening, however, saves lives. The National Lung Screening Trial,2 the most comprehensive and compelling of its kind, proved that screening high‐risk persons annually could reduce the lung cancer mortality rate by 20 percent. In fact, in 2010, the Data and Safety Monitoring Board, whose role was to assure scientific and ethical integrity and subject safety during the NLST, decided to end the trial early due to the compelling evidence that, indeed, lung cancer screening saves lives. Early detection of lung cancer is crucial to survival. To date, the only proven method of early detection is low‐dose CT for people 55 and older with a 30‐pack‐year smoking history.

Lung cancer disproportionately affects those on Medicare. Smoking history and age are the two primary criteria for screening. More than a third of the 50 million Americans on Medicare are former smokers. And another nine percent are current smokers.3 Consider the following facts from the National Cancer Institute: 4

  1. Lung cancer is most frequently diagnosed among people between the ages of 65‐74;
  2. The median age of those diagnosed with lung cancer is 70;
  3. More than 153,000 Americans age 65 and older will be diagnosed with lung cancer thisyear;
  4. More than 113,700 seniors will die from lung cancer this year.

According to research published in the March 27, 2014, issue of the journal “Lung Cancer,” if their insurance covered the procedure, most current and former smokers would welcome lung cancer screening. In compliance with the Affordable Care Act, by next year, most private insurance plans, including plans in health exchanges, and Medicaid expansion plans will be required to cover 100 percent of the cost for lung cancer screening for those at high risk. To deny this life‐saving benefit to Medicare recipients would be inhumane and unconscionable.

In addition to the incalculable value of the lives saved by early detection, studies have also established that lung cancer screening is cost‐effective. Both the cost of screening and the cost per life‐year saved compared favorably with screenings for other cancer screenings, according to a 2012 actuarial analysis of lung cancer screening. 5

Advocates serving the lung cancer community stand united on this issue. We believe senior citizens on Medicare should be entitled to the same lung cancer screening benefits afforded others on private insurance. We believe—regardless of a person’s smoking history—that all patients have a right to be treated with compassionate, equitable medical care. We urge you to include lung cancer screening as a covered benefit under Medicare.

—LungCAN—

About LungCAN

The Lung Cancer Action Network is an association comprising U.S.‐based 501(C)(3) advocacy nonprofit organizations united to serve as a vehicle, filter, incubator for the exchange of ideas and information. LungCAN facilitates and enhances opportunities for collaboration with the focus on lung cancer. For more information about LungCAN, visit LungCAN.org.

  1. U.S. Preventive Services Task Force Final Recommendations on Lung Cancer Screening, December 30, 2013, http://www.uspreventiveservicestaskforce.org/uspstf13/lungcan/lungcanfinalrs.htm
  2. New England Journal of Medicine, August 4, 2011, http://www.nejm.org/doi/pdf/10.1056/NEJMoa1102873
  3. Centers for Disease Control: 2012 National Health Interview Survey, Data table for Figure 8.3. Prevalence of current smoking among adults by age group (2012) http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201306_08.pdf
  4. Surveillance, Epidemiology, and End Results, (National Cancer Institute) SEER Stat Fact Sheets: Lung and Bronchus Cancer (accessed May 12, 2014) http://seer.cancer.gov/statfacts/html/lungb.html
  5.  “An Actuarial Analysis Shows That Offering Lung Cancer Screening As An Insurance Benefit Would Save Lives At Relatively Low Cost Health Affairs,” April 2013, http://www.veranmedical.com/assets/files/23/2012-millimanstudyinhealthaffairs1.pdf