Patient Pool Eligible for Lung Cancer Screening Expands Under Amended Criteria

By Jonathan Springston, Editor, Relias Media

The Centers for Medicare & Medicaid Services (CMS) has expanded access to lung cancer screening by revising age and smoking history criteria, changes that align with recommendations made last year by a national panel of medical experts.

First, CMS moved the starting screening age from age 55 years to age 50 years. Second, the agency lowered the threshold on the packs of cigarettes smoked per year from 30 to 20. In March 2021, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation calling for both changes. The two groups also call for any current smokers or those who have quit within the last 15 years who are in the designated age window to undergo screening.

The gold standard for lung cancer screening is the low-dose CT scan, a special X-ray that captures images of the lungs from various angles. The American Cancer Society backs screening as a key tool that has saved lives, but work remains.

In public comments made in December 2021, the American Lung Association asked CMS to set the top age limit for screening at 80 years (as USPSTF called for in its recommendations; CMS set the age limit at 77 years) and to remove the recommendation that says patients can end regular screenings once they have stopped smoking for 15 years (CMS kept this recommendation). Still, the association estimates these revised criteria could double the number of eligible patients for screening.

“CMS will give more people enrolled in Medicare access to lifesaving lung cancer screening. Screening for individuals at high risk is the only tool to catch this disease early when it is more curable,” Harold Wimmer, president and CEO of the American Lung Association, said in a statement. “Unfortunately, only 5.7% of people who are eligible have been screened, so it’s important that we talk with our friends and family who are at high risk about getting screened.”

For providers, CMS removed some administrative burdens — specifically, the radiologist who reads the low-dose CT does not have to document his or her participation in continuing medical education.

For more on this and related subjects, be sure to read the latest issues of Internal Medicine Alert and Primary Care Reports.