August 23, 2018

USPSTF Finalizes Lung Cancer Screening Research Plan

The U.S. Preventive Services Task Force (USPSTF) released its final research plan Aug. 16, 2018, for the scheduled update to its lung cancer screening guidelines.

The research plan is an essential preliminary step leading to publication of the task force’s update to its lung cancer screening guidelines. USPSTF recommendations for lung cancer and other preventive screening procedures potentially affect private insurance coverage decisions and individual physician referral practices for their patients.

The draft research plan was available for public comment from May 3–30, 2018. The American College of Radiology (ACR) collaborated with the Lung Cancer Alliance and The Society of Thoracic Surgeons to submit comments on the draft research plan.

The letter from the ACR and its coalition partners encouraged USPSTF to evaluate lung cancer screening from objective information reflecting current clinical studies and real-world implementation experience for the benefit of high-risk patients.

The final research plan incorporates some changes as a result. Specifically, the final research plan recognizes “low-dose CT” terminology used to describe the screening services rather than referring to it as a standard computed tomography. The task force recognized that the use of screening may result in a stage shift where more cancer cases are detected at an earlier stage of progression. The USPSTF added a contextual question about smoking cessation interventions among patients receiving low-dose computed tomography (LDCT) screening, and it added unnecessary treatment (e.g., surgical resection for a benign nodule), bronchopleural fistula and respiratory failure to the list of eligible harms.

The USPSTF’s current recommendations, published in December 2013, support the use of lung cancer screening with LDCT as a preventive health service for people who meet certain high-risk criteria.

As an arm of Health and Human Services, USPSTF is an independent body established by the federal government to evaluate preventive health services. The Patient Protection and Affordable Care Act requires private health insurers to provide, without patient cost-sharing, all preventive services that earn grades of A or B in USPSTF recommendations.