Update on Expanded Lung Cancer Screening Guidelines
September 23, 2021 | 2 min. to read
New federal recommendations will make lung cancer screening available to more people at a younger age. The new recommendations should help address disparities in cancer screening, because some population groups, including Black Americans, Native Americans and women, develop lung cancer at a younger age and with a less intensive smoking history than other groups, such as Caucasian men.
Most health plans are not required to offer coverage in accordance with the new criteria until January 1, 2023; however, Northwestern Medicine is working with commercial health insurance carriers to become early adopters, enabling more patients to obtain lung cancer screening with no out-of-pocket expense. NM also is updating Epic to accommodate the new lung cancer screening criteria and to make it easier for physicians to order screening for patients as individual insurers adopt the criteria, with completion expected by the end of 2021. Updates will be published in NM communications channels as the work progresses.
Reduce the recommended smoking intensity to 20 pack-years, from 30 pack-years
Expand the recommended age range for such screening to between 50 and 80 years of age, compared with the current range of 55 to 77 years
Maintain the recommendation that lung cancer screening is for patients who currently smoke, or who have quit smoking within the past 15 years
The new USPSTF recommendations, which are categorized as Grade B recommendations, are expected to nearly double the population eligible for lung cancer screening. Grade B or higher recommendations must be covered by most commercial health plans with no out-of-pocket expense to patients. Medicare and Medicaid programs do not follow USPSTF recommendations and have not implemented the new criteria.
Although CMS is currently reviewing the guidelines for lung cancer screening in Medicare beneficiaries, the agency's current guidelines remain in effect:
People between 55 to 77 years of age
People with a smoking history of greater than or equal to 30 pack-years
People who currently smoke, or who have quit smoking within the past 15 years
NM has made several recent investments to enhance its Lung Cancer Screening Program, including:
Purchasing radiology software to enhance patient tracking and nodule detection
Establishing a systemwide leadership team
Convening a system-level working group that involves physicians from several disciplines and operational leaders from all NM regions to develop synergies and standards for screening
Launching a new web page to help patients learn about the Lung Cancer Screening Program