Non-Small Cell Lung Cancer Coverage from Every Angle

Is Lung Cancer Screening Effective in the Community Setting?

By: Lauren Harrison, MS
Posted: Wednesday, July 24, 2019

Screening for lung cancer by low-dose computed tomography in both community and academic centers under the Centers for Medicare and Medicaid services (CMS) regulations is successful at detecting cancers at earlier and more treatable stages. Along with her colleagues, Amy Copeland, MPH, of the GO2 Foundation for Lung Cancer in Washington, DC, published their results assessing screening implementation from the first full year of CMS coverage for lung cancer screening in the Journal of Oncology Practice.

“In this study, we not only demonstrate that lung cancer screening is happening in the community setting, but also that nonacademic screening programs are using similar protocols and are seeing similar findings as academic medical centers…. We found a shift toward early-stage diagnosis in both settings,” concluded the authors.

In their study, researchers identified 165 lung cancer screening centers that were designated Screening Centers of Excellence and distributed a survey regarding their 2016 program data and practices. The survey looked at screening implementation, workflow, number of screening tests completed, and cancers diagnosed. These centers were mostly community-based (62%) and had a broad geographic distribution.

More than half of lung cancers were diagnosed at stage I or at a limited stage in both the academic and community centers. The most common diagnosis (49%) was stage I non–small cell lung cancer. The Lung Imaging Reporting and Data System results were also comparable between the two settings, with 6.7% and 6.5% of scans having a category 4 designation for academic and community centers, respectively.

Of the 165 screening centers, 149 responded to questions about barriers to providing screening. More than half of the respondents listed insurance and billing issues, lack of patient awareness of screening availability, internal workflow issues, and provider referral issues as barriers to lung cancer screening.

Disclosure: The study authors’s disclosure information can be found at

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