Washington, D.C.– The Medical Imaging & Technology Alliance (MITA) has submitted comments on the United States Preventive Services Task Force (USPSTF) draft recommendation statement on lung cancer screening. While strongly supportive of the recommendation to expand the population eligible for lung cancer screenings, MITA also expressed concern about the potentially arbitrary limitations the recommendation places on specific segments of the population.

“The USPSTF proposal is commendable in that it expands the population eligible for lung cancer screening,” noted MITA Executive Director Patrick Hope in the letter. “This will lead to improved outcomes for thousands of patients a year, and it also takes into account the significant amount of scientific research published since the issuance of the current recommendation statement.”

If finalized as proposed, the USPSTF draft proposal would appropriately expand on the current recommendation by lowering the eligibility age to 50 years and the pack-year smoking history to 20 years.
While supportive of the expanded eligibility criteria, MITA also outlined several reservations with the proposal.

“We are concerned about potentially arbitrary limitations on the eligible population in the USPSTF draft recommendation statement,” added Hope. “The USPSTF continues to recommend a 15-year smoking cessation quit date and an upper age limit of 80 years. We strongly recommend that the smoking cessation quit date and the upper age limit cut-off be removed. The decision to prescribe lung cancer screening should be left to a patient and their physician who best understand the individual patient’s personal health history and overall health status.”

To ensure that the recommendation more appropriately addresses additional at-risk populations of smokers, MITA urged the USPSTF to consider real-world evidence, post-market surveillance data, as well as other well-designed research approaches. Putting greater emphasis on these elements and amending and refining risk-based guidelines for low dose CT screening would help to address population segments known to be at higher health risk.

Additionally, the letter also expressed concern over the continued USPSTF emphasis on what it considers to be the “harms” of lung cancer screening, including ionizing radiation exposure and detection of “incidental findings.” MITA urged the Task Force to recognize the significant improvements made over the last decade in radiation dose optimization in CT technology. In particular, modern CT systems comply with NEMA XR 29-2013 “Standard Attributes on CT Equipment Related to Dose Optimization and Management,” which identifies the relevant features of a CT scanner that help to perform optimization and or management of ionizing radiation doses while still enabling the system to deliver the diagnostic image quality needed by the physician.

“Despite the reservations that we have outlined, MITA is supportive of the Task Force recommendation. We look forward to our continued work with policymakers, patient advocates, healthcare providers, and others to expand access to advanced diagnostic screening for at-risk Americans,” said Hope.

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