The U.S. Centers for Medicare and Medicaid Services (CMS) has released detailed information in preparation for the April 30 meeting of the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) to review the evidence on CT lung cancer screening.
The new information includes the meeting agenda, lists of voting panelists, invited speakers, and lists of questions. No radiologists are among the voting members on the panel; however, several advocates of CT screening were invited to speak, including Laurie Fenton-Ambrose, president and CEO of the advocacy group Lung Cancer Alliance.
Other speakers who are well-known to the radiology community include Dr. Ella Kazerooni from the University of Michigan; Dr. Michael McNitt-Gray, PhD, from the University of California, Los Angeles; Dr. Claudia Henschke, PhD, from Icahn School of Medicine at Mount Sinai in New York City; and Dr. Charles White, from the University of Maryland, each of whom was asked to present a four-minute commentary.
The panel will be headed by Dr. Rita Redberg of the University of California, San Francisco. At the end of the day, panelists will vote on three main questions and several subquestions, all having to do with the strength of the evidence regarding screening of the Medicare population with low-dose CT (at an average effective dose of 1.5 mSv), as well as the panelists' confidence that the potential harms of screening will be minimized in this population.
The main questions to be presented to panelists are as follows:
- How confident are you that there is adequate evidence to determine if the benefits outweigh the harms of lung cancer screening with low-dose CT?
- How confident are you that the harms of lung cancer screening with low-dose CT if implemented in the Medicare population will be minimized?
- How confident are you that clinically significant evidence gaps remain regarding the use of low-dose CT for lung cancer screening in the Medicare population outside a clinical trial?
The meeting, to be held at CMS' headquarters at 7500 Security Blvd. in Baltimore from 7:30 a.m. to 4:30 p.m., will be open to the public. CMS aims to help determine whether CT lung cancer screening should be covered as a preventive service under Medicare for high-risk individuals with a long history of smoking.
The meeting is part of a CMS review following the December 2013 recommendation by the U.S. Preventive Services Task Force (USPSTF) giving CT screening a grade B recommended rating for high-risk individuals.
CMS is interested in evidence that helps inform the identification of individuals eligible for screening, the appropriate frequency and duration of screening, and facility and provider characteristics that predict benefit or harm. The agency also seeks input on the influence of such screening factors on patient education and informed consent, especially for elderly and younger disabled populations, and information on the integration of smoking cessation programs into screening.
More information about the MEDCAC meeting is available on the CMS website.
