Lung Cancer Screening and Evidence-Based Policy | Cancer Screening, Prevention, Control | JAMA Forum Archive | JAMA Network
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Lung Cancer Screening and Evidence-Based Policy

Many people have dreamed of a day when health policy might be based less on the political clout of special interest groups and more on research evidence. Evidence-based health policy could lead to more rational decision-making than typically occurs today. For this to work, however, we need a process to collect and consider all of the relevant evidence before formulating a policy.

The discussion surrounding the use of computed tomography (CT) scanning to screen for lung cancer is a case in point.

The Affordable Care Act (ACA) included a provision that requires private health insurers to cover, at no cost to their beneficiaries, “[e]vidence-based items or services that have in effect a rating of A or B in the current recommendations of the United States Preventive Services Task Force (USPSTF) . . . .” On its surface, this sounds like a logical approach for translating evidence from research on preventive services into policy. The ACA removes patients’ financial barriers to receiving the most efficacious preventive services; it also requires health insurers to invest in preventive care and creates a level playing field for them to do so. However, the evidence that the USPSTF finds relevant for its recommendations is not the only thing important to consider in establishing a policy on coverage for a potential preventive service.

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