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WASHINGTON, D.C. [May 7, 2012]—Lung Cancer Alliance, Legacy and Prevention Cancer Foundation protested “unconscionable delay” in the federal government’s review of CT screening for those at high risk for the early detection of lung cancer and sent a letter urging Secretary of Health and Human Services (HHS) Kathleen Sebelius to intervene.
The letter, sent by the three national organizations to Secretary Sebelius last week, objected to the “the lethargic pace” of the United States Preventive Services Task Force (USPSTF) in reviewing CT screening for lung cancer.
Giving CT scans to a high risk population with no symptoms of lung cancer was scientifically proven to be effective in dramatically reducing deaths by a large randomized controlled trial terminated in November of 2010 by the National Cancer Institute (NCI).
USPSTF recently told Lung Cancer Alliance that their review would not even reach the public comment stage until spring of 2013.
“There is no sense of urgency on the part of the USPSTF,” said Laurie Fenton Ambrose, Lung Cancer Alliance President & CEO, “which is why we felt it was important to elevate our concerns to the highest level by writing to Secretary Sebelius and asking her to expedite this process.”
The USPSTF is a federally funded agency that rates screening and other procedures with letter grades which are used to determine coverage by Medicare and private insurers.
The most recent review of CT screening for lung cancer was carried out in 2004, and at that time USPTF gave it an “I” rating, stating there was insufficient evidence to recommend for or against screening.
However, in November, 2010, the National Lung Screening Trial, one of the largest ever carried out by NCI, had to be terminated as soon as it became evident that those screened with CT scans had 20% fewer deaths than those screened with chest x-rays.
The 20% is a floor, not a ceiling, which subsequent analyses indicates could be two to three times higher - a profound mortality reduction far greater than current breast or prostate cancer screening.
Immediately following the announcement in 2010, Lung Cancer Alliance, Legacy and Prevent Cancer Foundation wrote to the head of the Agency for Healthcare Research and Quality, which houses the USPSTF, urging expedited review.
The initial response stated that the draft findings for public comment would be issued in early 2012. A second response last month pushes the date for draft comments out to spring of 2013, meaning that a final recommendation may not be issued until 2014.
Meanwhile, over 225,000 smokers, former smokers and never smokers will be diagnosed with lung cancer this year, primarily at late stage, and that number is expected to increase by 50% over the next 20 years.
Calling the delay “unconscionable,” the letter went straight to the HHS Secretary and also notes that would likely mean that CT screening for lung cancer would be excluded from coverage under health care reform.
“This would be a de facto denial of this life-saving benefit for those who are at highest risk,” Fenton Ambrose added.
In February, Lung Cancer Alliance issued a first of its kind “National Framework for Lung Cancer Screening Excellence and its Continuum of Care” for the public and for screening sites in an effort to implement quality standards and guidelines for those at risk in a responsible, safe, cost-effective and equitable way. Over a hundred sites have now committed to the National Framework.
To view the letter, click here.
To view the National Framework for Lung Screening Excellence, click here.