In a move that surprised and disappointed lung cancer doctors and other experts on Wednesday, a Medicare panel advised against covering low-dose CT scans to detect the disease early.
The panel, a nine-member body that issues nonbinding recommendations to the Centers for Medicare and Medicaid Services, determined that there isn't enough evidence to justify annual CT scans to detect early lung cancer in smokers, as recently recommended by the U.S. Preventive Services Task Force.
The task force's move to embrace low-dose CT scans for lung cancer screening had been lauded by doctors and patient advocates as a major victory against the disease, a leading killer of men and women in the United States. The National Lung Screening Trial and studies based on it had found that the scans are effective in detecting lung cancer at an early stage, and that the screening could save more than 12,000 lives each year if every screening-eligible American received an annual scan.
“Lung cancer with low-dose radiation CT scanning saves lives,” Raz has said. “There’s no doubt about it. The studies clearly show that. Lung cancer screening really has the potential to revolutionize and change the face of lung cancer from a disease that we can cure sometimes to a disease we can cure most of the time.”
Without standard lung cancer screening, only about 15 percent of patients have their cancer detected at an early stage. Studies predict that with screening, about 80 percent of lung cancers could be detected at Stage 1, when they’re most easily treated.
Lung cancer is the leading cause of cancer death in the United States, killing nearly 160,000 each year. Nearly 90 percent of people who develop lung cancer die from the disease, in part because it’s often not detected until it’s already advanced and spread.
The Medicare panel did take into account the National Lung Screening Trial, which found a 20 percent reduction in deaths among current and former pack-a-day smokers over age 55 screened with low-dose CT scans versus chest X-rays. However, the study was not enough to sway the panel to recommend a new coverage policy to the Centers for Medicare and Medicaid Services (CMS).
The CMS will release a proposed decision memo in November and a final national coverage decision by February 2015.
For patient advocates, the fight isn’t over.