MEDCAC to Review Medicare Coverage of CT Scans for Smokers

On April 30, CMS will convene the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) to decide if Medicare will cover annual screenings for lung cancer with low-dose CT scans for current or past heavy smokers.  You can view the meeting here.



I am a voting member of MEDCAC and was invited to serve on this panel.  But I had a prior engagement: the ASBH program committee meeting in Chicago.  Too bad.  This is an important and difficult issue. 



In December 2013, the United States Preventive Services Task Force (USPSTF) recommended screening of asymptomatic adults aged 55 to 80 years who have a 30 pack/year smoking history and currently smoke or have quit within the past 15 years. The ACR, the Lung Cancer Alliance, the Society of Thoracic Surgeons and 38 other medical organizations want CMS to provide full national coverage for high-risk patients as defined in the USPSTF and provide coverage with evidence for other high-risk patients not included in USPSTF recommendations using data collected through existing registries.



Indeed, smoking-related lung cancer kills over 100,000 Americans each year.  The low five-year survival rate is attributed to the late diagnosis of the disease.



Nevertheless, as with recent debates over routine mammograms for women under 50 and PSA tests for men, the harms could outweigh the benefits.  Annual CT screenings mean a lot of radiation and a lot of false positives and unnecessary follow-up.