Dept. of Veterans Affairs to Cover CT Screening for Lung Cancer

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Advocates for broader coverage for low-dose CT lung cancer screening in patients with a heavy smoking history and other risk factors are cheering news that the Department of Veterans Affairs (VA) will follow the lead of some private payors and cover the testing ahead of a Medicare coverage decision.

The VA decision was announced by the Lung Cancer Alliance (LCA), a non-profit patient advocacy group funded largely by private donors, medical centers and pharma companies, according to its annual report. The LCA’s president and CEO, Laurie Fenton Ambrose, stated that she received the news in a written correspondence from Robert Petzel, the VA’s under secretary for health.

Last year, Wellpoint, one of the nation’s larges insurers and an independent licensee for Blue Cross & Blue Shield, was the first insurer to issue a national decision to cover low-dose CT screening for lung cancer for its more than 34 million members.

Because of concerns about radiation, costs, uneven screening accuracy, false positives and the risks of complications from lung biopsies, Wellpoint carefully restricted coverage to only patients who matched the criteria of the federally-funded National Lung Screening Trial that in 2010 found that screening current and former heavy smokers with low-dose CT scans was tied to a 20% reduction in lung-cancer deaths. These criteria included being 55 to 74 years of age and having smoked the equivalent of 30 pack years. (Read more about Wellpoint here.)

The American Lung Association, the American College of Chest Physicians, the American Society of Clinical Oncology, the American Cancer Society, and the National Comprehensive Cancer Network, are just some of the organizations that have updated their lung cancer screening guidelines to include CT screening for the type of heavy smokers that the National Lung Screening Trial enrolled. However, the U.S. Preventive Services Task Force, a government-appointed panel upon which Medicare relies heavily for guidance, is still examining the issue.

Not content to wait for Medicare and individual insurance companies to decide if they want to cover the testing, LCA has been turning up the political pressure for coverage by collecting co-sponsors on a House and a Senate bill to cover CT lung cancer screening. The House bill (H.R. 1394) has 75 co-sponsors as of this week and the Senate bill (S.752) has 30 co-sponsors.

In addition. the LCA has run an edgy advertising campaign called “No One Deserves to Die” that tackles head-on the idea that heavy smokers knowingly endangered their health and may therefore be undeserving of advanced medical treatments to save them from the potentially deadly consequences of their habit. Click here to see the ads.

The VA’s decision will certainly help the LCA’s cause. "I am so pleased that high level engagement with senior VA officials has borne fruit," said Fenton Ambrose in the press release.