Letters to the Editor

A reader responds to ACP Internist coverage about USPSTF recommendations on annual screening for lung cancer with CT.

Closing lung screening loopholes

Charlotte Huff's front-page article in the March 2022 ACP Internist (“Lung screening's benefits, challenges”) provided an excellent review of the clinical utility of lung cancer screening, as well as the important role internists play in shepherding patients through the process.

However, I've been stymied with implementing the U.S. Preventive Services Task Force's (USPSTF) recommendation on annual screening with low-dose computed tomography for some patients whose insurance didn't cover the test. Although the Affordable Care Act mandates that insurance companies cover all preventive services that have a USPSTF A or B recommendation, such coverage need not be immediate. As the American College of Radiology notes in a document monitoring the status of coverage for lung cancer screening, “Payers are given up to one year from the start of the next plan year to update their coverage policies when USPSTF guidelines are changed.”

This is unacceptable. There should be no loopholes. There should be no disparity in the availability of testing based on insurance coverage. This is a useful preventive intervention whose implementation can save lives.

Eric C. Last, DO, FACP
Wantagh, N.Y.