CMS Initiates National Coverage Analysis for Lung Cancer Screening

CMS today announced that it would initiate a National Coverage Analysis on lung cancer screening with low-dose CT.

The action was taken in response to two formal requests to initiate the NCA, one from Peter B. Bach, director, Center for Health Policy and Outcomes, Memorial Sloan-Kettering Cancer Center; the other one came from Laurie Fenton Ambrose, president & CEO, Lung Cancer Alliance.

CMS has the authority to initiate such a review if a service is recommended with a grade A (strongly recommends) or a grade B (recommends) by the United States Preventive Services Task Force (USPSTF). The USPSTF gave low-dose CT lung cancer screening for high-risk individuals a grade B recommendation in December of last year.

The announcement initiates a 30-day public comment period that ends on March 12, 2014. CMS is particularly interested in evidence to inform:

• identification of patients eligible for screening;

• the appropriate frequency and duration of screening;

• facility and provider characteristics that predict benefit or harm;

• specific criteria for test positivity; and

• the impact of false positive results and follow-up tests or treatments.

The agency is also asking for input on patient education and informed consent in Medicare beneficiaries, including the elderly and younger disabled populations and persons receiving dialysis treatment for end stage renal disease; and on integrating smoking cessation interventions for current smokers.

CMS strongly recommends submitting comments through the web site.

A Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) meeting will convene on April 30, 2014, to review the available evidence on the topic.

Lead analysts for the LDCT lung cancer screening NCA are Lori Ashby,, 410-786-6322; and Jamie Hermansen,, 410-786-2064. Lead medical officer Joseph Chin, MD, MS.