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New lung screening and coverage guidelines expand access to lung screening in America

Lung Specialist – Lauren Reilly – Published on March 16, 2022

Lung cancer screening has made the news over the last few months through big changes to eligibility and reimbursement. In late 2021, the United States Preventative Services Task Force (USPSTF) announced expanded eligibility for lung screening,1 and just like that, 8 million more Americans were eligible for this potentially lifesaving screening. However, this recommendation was not accompanied by updated reimbursement, so it left the medical community unsure how to implement the new guidelines.

Then, the 2022 US cancer statistics2 were released and lung cancer was again identified as the deadliest cancer for all Americans. This statistic is a sobering reminder that more needs to be done to identify those most at risk of developing lung cancer and to encourage lung screening.

On February 10, 2022, the Centers for Medicare & Medicaid Services (CMS) made their move. They expanded eligibility for Medicare beneficiaries to receive insurance coverage for low-dose lung CT screening (LDCT).3 LDCT is widely regarded as the most effective form of lung screening for lung cancer detection and is the only form of screening that has been proven to detect lung cancer early before symptoms occur.4 In other words, this screening can lead to potentially life-saving treatments for patients at high risk of developing lung cancer.4,5

The expanded screening eligibility and reimbursement are good news for patients and medical providers, but the addition of 8 million people to schedule for screening is a daunting challenge. The latest USPSTF guidelines indicate individuals are high-risk1 if they:

  • Are between 50 and 80 years of age.
  • Currently smoke or have quit smoking within the past 15 years.
  • Have a 20 pack-year smoking history (pack years are calculated by multiplying the number of cigarette packs a patient smokes per day by the number of years they smoked daily.)

Additionally, the CMS has expanded their coverage to thousands of independent diagnostic testing facilities across the United States, as long as providers still use Lung-RADS for results reporting.3 This is important because Lung-RADS reporting provides a consistent method for reporting and tracking so that individuals at high risk can be monitored.

What is truly needed is the creation of more lung screening programs to help address the large screening population and help catch more cancers earlier. Discussing lung screening as part of overall patient management procedures at general practices, OBGYNs, family practices, and other physician offices can help communicate the option for lung screening to those in the targeted screening population.

Volpara Health is committed to supporting lung screening providers and ensuring that high-risk patients get the care they need. To learn more about how Volpara LungTM could benefit your program and help manage patients from screening to diagnosis to treatment, reach out to