Expert urges caution in considering lung CA screening options

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Decision not to include low-dose computed tomography screening for lung cancer under Medicare may affect lung cancer disparity rates.

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Lung Cancer

Smokers with clear lungs still have cancer signs
Smokers with clear lungs still have cancer signs

HealthDay News -- The benefits and harms of low-dose computed tomography (LDCT) screening for lung cancer need to be carefully considered before Medicare decides on its coverage policy.

In April 2014, the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) gave a vote of low confidence in the benefits versus harms of LDCT screening.

“Many were shocked by the outcome: a vote of low confidence about whether the benefits of LDCT screening would outweigh harms among Medicare beneficiaries in a community setting,” Renda Soylemez Wiener, MD, MPH, of Boston University School of Medicine wrote in an editorial published in the Annals of Internal Medicine.

Deciding against LDCT screening coverage could potentially increase the socioeconomic- and age-based disparities in lung cancer outcomes, according to the author. Weiner lists two alternative strategies:

  1. Centers for Medicare and Medicate Services (CMS) could determine coverage during a period of evidence development.
  2. CMS could offer LDCT screening coverage when conducted in certified facilities that provide comprehensive, patient-centered programs

"To avoid the hard lessons learned from overzealous implementation of prostate cancer screening, we must get implementation of LDCT screening right from the outset," wrote Weiner.


  1. Weiner R. Ann Intern Med. 2014; doi:10.7326/M14-1352
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