Under a proposed national coverage decision, Medicare would pay for women to get a joint Pap smear and human papillomavirus test every five years to screen for cervical cancer.
“Based on a systematic review of the evidence, we propose that HPV and Pap smear co-testing in Medicare beneficiaries using an FDA-approved test is reasonable and necessary for the prevention or early detection of illness or disability and appropriate for Medicare beneficiaries,” the CMS said in its proposed coverage notice.
Medicare now covers a screening pelvic examination and Pap test for all female beneficiaries at 12 or 24 month intervals but does not cover HPV testing. The scope of the current review is limited to screening for cervical cancer, along with HPV testing.
The CMS is taking comments on its proposed decision through May 16, and plans to issue a proposed decision by August 2015.
The agency has not yet performed an analysis of what it would cost to grant coverage for the joint testing. A Pap smear generally costs about $40 per screening and HPV tests cost between $50 and $100.
Combination Pap smear and HPV testing every five years for women ages 30 to 65 received a grade A recommendation from the U.S. Preventive Services Task Force in March 2012.
An estimated 12,900 new cases of invasive cervical cancer were expected to be diagnosed in the U.S. by the end of 2015, according to the American Cancer Society, and 4,100 women with the disease may die from it this year. Most cervical cancers occur among women who have never been screened or who have received inadequate screening.
Cervical cancer tends to occur in midlife, with most cases found in women younger than age 50, the cancer society says. But more than 15% of cervical cancer cases are diagnosed in women over 65.
The five-year co-test screening strategy has been endorsed by various provider groups, including the American Academy of Family Physicians, the American Cancer Society, the American Congress of Obstetricians and Gynecologists, the American Society for Clinical Pathology and the American Society for Colposcopy and Cervical Pathology. The proposed decision comes just three days after the CMS finalized its decision to cover HIV/AIDS screenings for Medicare beneficiaries without regard to perceived risk behavior.
