MedicalResearch.com Interview with:
Phillip M. Boiselle, MD
Professor of Radiology and Associate Dean for Academic and Clinical Affairs
Harvard Medical School
Beth Israel Deaconess Medical Center
Medical Research: What is the background for this study?
Dr. Boiselle: We surveyed leading academic medical centers in 2013 and found considerable variability in their practice patterns as well as a relatively small number of patients being screened for lung cancer at these sites. Considering landmark developments since that time, including favorable policy and payment decisions by USPSTF and CMS and development of radiology-specific nodule guidelines by the American College of Radiology, we were curious to see whether there would be greater conformity of practice patterns and increased patient volumes in response to these developments.
Medical Research: What are the main findings?
Dr. Boiselle: First, our finding of greater conformity of lung cancer screening practices at present compared to 2013 confirmed our hypothesis that the development of radiology-specific guidelines by ACR would contribute to greater uniformity.
Second, we were surprised by the very modest level of increase in patient volumes for CT screening over time despite the favorable USPSTF and CMS decisions. We emphasize, however, that the timing of our survey occurred too early to determine the full impact of CMS coverage on patient volumes
Medical Research: What should clinicians and patients take away from your report?
Dr. Boiselle: Broad adoption of ACR Lung-RADS™, with associated greater conformity regarding threshold nodule size criteria for a positive screen at leading academic medical centers, is a positive development that will help to ensure a uniform quality experience for patients undergoing lung cancer screening at these sites and other sites throughout the country who have adopted these radiology-specific screening guidelines.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Boiselle: We plan to continue our longitudinal survey of these sites to determine the impact of CMS coverage on patient screening volumes, which we anticipate will show more substantial increases in the near future—-in response not only to CMS coverage, but also to greater awareness of CT screening by referring physicians and patients at high risk for lung cancer who meet eligibility.
Boiselle PM, White CS, Ravenel JG. Computed Tomographic Screening for Lung Cancer: Current Practice Patterns at Leading Academic Medical Centers. JAMA Intern Med. 2014;174(2):286-287. doi:10.1001/jamainternmed.2013.12693.
Phillip M. Boiselle, MD (2016). Only Small Increase in CT Screening for Lung Cancer Despite New Guidelines