What do I say if my patient wants to be screened for lung cancer?

Recently the Centers for Medicare & Medicaid Services (CMS) has determined that “the evidence is sufficient to add a lung cancer screening counseling and shared decision making visit, and for appropriate beneficiaries, annual screening for lung cancer with low dose computed tomography (LDCT), as an additional preventive service benefit under the Medicare program”.

http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274

The inclusion criteria are similar to those chosen for the NLST trial and will include:

  • Age 55-77
  • Asymptomatic
  • 30 pack year hx
  • Current smoker or prior smoker that has quit within last 15 years

This means that your medicare/medicaid patients are eligible for lung cancer screening. It will now be up to the physician to counsel their patients and with “shared decision making” will determine if a patient should undergo LDCT to screen for lung cancer.

This morning we had a great discussion with Dr. Johnson in morning report and he showed us that the NLST has actually created a very user friendly study guide. The benefit of this study guide is that it puts the trial’s conclusion into easily understandable absolute numbers that help demonstrate the risks and benefits to your patient. Take a look so are prepared next time your clinic patient asks you about it!

http://www.cancer.gov/newscenter/qa/2002/NLSTstudyGuidePatientsPhysicians