“We joined this effort at a time when screening using low dose CT scanning was not the norm,” explained Dr. Mayfield.
WellStar’s participation in the I-ELCAP trial was discontinued and screening was made available in a community setting after the National Cancer Institute (NCI) released the results of the National Lung Screening Trial (NLST) in 2010. The NLST compared the effectiveness of low-dose CT with standard chest X-ray in detecting lung cancer in a limited population of current and former smokers. The results showed that participants on the CT arm had a 20 percent lower risk of dying from lung cancer than those receiving the chest X-ray.
In spite of this $250-million study of more than 50,000 people with the most profound results in history, the issue of lung cancer screening and reimbursement failed to move forward due to lack of a positive recommendation from the U.S. Preventive Services Task Force (USPSTF).
As one of the leading screening centers in the nation, WellStar, in collaboration with the Lung Cancer Alliance (LCA), has been working to advocate for national screening guidelines and USPSTF validation. This collaboration has resulted in the development of National Framework for Excellence in Lung Cancer Screening, a publication of guidelines, which is being used by screening centers across the country to ensure safe, responsible care.
“Dr. Mayfield is one of the most dedicated and patient focused doctors we work with throughout the country,” explained Laurie Fenton Ambrose, Lung Cancer Alliance President & CEO. “He has been a leader in the field of lung cancer and has worked tirelessly to bring screening to those who need it most. Besides all of that, he is down to earth and very fun to be around. Working with him has been entirely our pleasure and his work is truly saving lives.”
In April 2013, Dr. Mayfield was called upon by United States Senator, Dianne Feinstein, Calif., and United States Senator, Saxby Chambliss, Ga., to be a part of an expert panel during a Senate Education Hearing on lung cancer screening. The panel discussed the importance of the NLST as a national standard and urged Washington to put pressure on the USPSTF for a recommendation. As of Tuesday, July 30, 2013, that recommendation was released and gives lung cancer screening a Grade B rating. Translated, this means there is sufficient evidence to indicate a benefit and that providers should offer the service. Which marks another milestone in the tenacious battle to bring lung cancer screening to the forefront.
“We feel like we’ve really moved the ball,” explained Dr. Mayfield. “This wasn’t something WellStar had to do or be a part of, but with the support of senior leaders, the program became a reality.”
Currently, the draft recommendation has been posted for public comment on the Task Force website at www.uspreventiveservicestaskforce.org. Comments can be submitted through August 26, 2013 at www.uspreventiveservicestaskforce.org/tfcomment.htm.
After the 30-day comment period has ended, the Task Force will review the comments and make a formal recommendation. If approved and published, the screenings could be covered by Medicare and Medicaid with commercial insurers following suit. However, not all insurers are waiting on the USPSTF. WellPoint, the largest insurer in the nation, announced coverage reimbursement for high risk members long before the July announcement.
“WellPoint should be commended for covering screenings for the past two years,” shared Dr. Mayfield. “They didn’t wait.”
WellStar has screened more than 1,000 patients, diagnosing 22 cancers, 18 of those lung. Of the lung cancers detected through screening, 80 percent are in stage one or two. Early detection is key to lung cancer survival.
“Dr. Mayfield’s role with the NLST & LCA are a true testament to progressive and preventive medicine that helps our System stay ahead of the curve,” said Robert Jansen, M.D., executive vice president, WellStar Medical Group president & chief administrative medical officer. “Through his leadership and dedication to this effort, Dr. Mayfield is making an impact on not only a local level, but a national movement.”
To learn more about the LCA, visit www.lungcanceralliance.org. To read more about WellStar’s screening program, visit wellstar.org.
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