USPSTF to focus on Lynch syndrome

The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer panel of experts who make evidence-based recommendations about disease prevention. While USPSTF is not part of the Federal Government, their recommendations generally determine what clinical services are paid for by Medicare and most private insurance. For example, after USPSTF recently determined that colorectal cancer screening should begin at age 45, the Centers for Medicare and Medicaid Services (CMS) adopted their recommendation and it is now covered by almost all health insurance companies. 

This month, USPSTF announced plans to conduct an extensive evaluation of Lynch Syndrome evidence to determine how to best reduce mortality and improve quality of life. Lynch Syndrome is the most common cause of hereditary colorectal cancer, resulting in 4,200 cases per year. It is also more common in younger adults than in other forms of colorectal cancer.

Some of the questions USPSTF will seek to answer include:

• What are the benefits of risk assessment, genetic testing, and genetic counseling?
• What is the accuracy of next-generation sequencing for detecting Lynch Syndrome?
• What is the effectiveness of preventive interventions for reducing mortality and improving quality of life? What risks are associated with these interventions?

While the outcome of this study is vitally important, it will likely take eighteen months or more to complete. Timeliness remains a problem at USPSTF. As it is an all-volunteer organization with limited funding, it often takes considerable time to complete a study. 

This is why the Alliance advocated for increased funding for USPSTF last year and will do so again in the next appropriations cycle. If our government will continue to rely on an independent, all-volunteer organization to determine what preventive services are paid for, then the government needs to provide adequate funding so work is completed in a timely manner.

In addition to this important work on Lynch Syndrome, the Alliance has called on USPSTF to evaluate the effectiveness and risks of blood screening for colorectal cancer. Blood screening has the potential for seamless integration into routine clinical practice, but it is not covered by Medicare and likely will not be until there is a recommendation by USPSTF.