In a viewpoint perspective published in JAMA on March 9, 2021, a University of North Carolina Lineberger Comprehensive Cancer Center researcher and two other experts endorsed the Center for Medicare & Medicaid Services’ (CMS) requirement for a patient and their doctor to engage in a shared discussion of benefits and harms before proceeding with a low-dose spiral computed tomography (LDCT) scan as a method for preventing lung cancer death. An accompanying evidence report detailed the benefits and harms from screening, suggesting that shared decision-making between a patient and their health care professional is crucial in ensuring screening is used optimally and with fully informed consent.
“In our view, CMS should continue to require, as well as pay for, shared decision-making, including associated tobacco counseling, for people being considered for annual lung cancer screening because having yearly CT screening is a consequential decision,” said Daniel Reuland, MD, MPH, one of the review authors, a member of the UNC Lineberger Comprehensive Cancer Center, and a professor in the division of General Medicine and Clinical Epidemiology at UNC School of Medicine. “Patients should understand the benefits, harms and costs involved, and their values and preferences should be considered. Because the decision-making process can be time-consuming, we also think shared decision-making could be done by trained, non-physician staff.”
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