Lung Cancer Screening Is Not as Prevalent as it Should Be
Many people might not know that lung cancer is the leading cause of cancer deaths in the United States. It is actually responsible for more deaths than colon, breast, and prostate cancers combined. Three out of four people are diagnosed with lung cancer at an advanced stage when it is harder to treat, according to a 2026 report by the American Cancer Society. Another problematic trend is that lung cancer cases have been increasing among younger adults, particularly women and people of Asian descent, as well as those who have never smoked. There are questions as to why there are not people being screened for lung cancer like other cancers.
The U.S. Preventative Services Task Force (USPSTF), an independent panel of national experts in evidence-based medicine, recommends annual screening for lung cancer with a low-dose CT (computed tomography) scan in only select populations. This includes adults aged 50 to 80 years who have a 20 pack-year smoking history and who either currently smoke or have quit within the last 15 years. (A pack-year equals smoking one pack, or about 20 cigarettes, per day for a year). Some experts believe these guidelines should be broadened. One doctor believes the screening model is outdated. It presumes smoking is the only cause of lung cancer, so people exposed to secondhand smoke, air pollution, or radon, all well-established risk factors, don’t have a way of getting screened.
In a study published in a November 2025 issue of JAMA Network Open, doctors examined the records of nearly 1,000 people treated for lung cancer and found that only 35 percent of them met the USPSTF criteria for screening. If lung cancer screening was expanded to include all people ages 40 to 85, the researchers estimate that this would detect 94 percent of lung cancers, which would prevent at least 26,000 deaths annually. People need to understand that they are not immune to lung cancer even when they don’t smoke. Early detection is the only way to treat early-stage lung cancer. Stage I lung cancer is completely curable, and treatment is an outpatient procedure.
Even with the current guidelines, most people who are eligible for screening do not get screened. The reason is lack of public awareness. Research shows that less than 20 percent of eligible people are getting screened. Screening numbers could be low because it is a very cumbersome process. Lung cancer screening consists of a shared decision-making visit with your doctor to discuss the risks and benefits, then getting a CT scan. It is a two-step process compared to getting a mammogram or colonoscopy for instance. People argue against expanding screening because they say it will cost too much, but doctors say the cost of treating stage IV lung cancer far exceeds the cost of treating stage I lung cancer.
People are also worried about radiation with low dose CT scans. The radiation risk is low, with the amount of radiation people receive being slightly higher than a mammogram. People might also be worried about incidental findings, which are conditions that are not lung cancer. It could be a benign legion or a fungal infection, but these can be beneficial if they are actionable. There is another potential benefit from receiving low dose CT scans of the lungs. A single scan can look at the heart and bone health by providing cross-sectional images of the whole chest cavity, including the heart and thoracic spine.
Some doctors believe that lung cancer screening should be universal after the age of 40, regardless of whether people have a history of smoking. With a universal approach, the interval could be different based on people’s personalized risk. There are personalized recommendations for colon and breast cancer screening, based on people’s risk factors. This needs to be figured out for lung cancer as well. Until screening recommendations are broadened, it is important for people to be proactive about this issue. If you are eligible to get screened, get screened and if you have a family history of lung cancer discuss it with your doctor.
Also, if you’ve ever smoked or had a prior cancer, particularly breast cancer, be sure to discuss it with your doctor. Also be sure to bring persistent symptoms like persistent cough up to doctors. While insurance coverage for low-dose CT lung cancer screening tracks closely with the USPSTF recommendations, your doctor may be able to get you coverage even if you don’t fit the parameters. A physician could make a clinical decision based on their concerns about your risk for lung cancer and could prescribe a CT scan or help you find an affordable option near you if you’ll be paying out of pocket. The out-of-pocket cost is usually $300 to $500. The most important part of lung cancer screening is the survival benefit. The five-year survival rate for stage IA lung cancer is 90 percent, compared to 20 percent for stage III. This is especially important because the majority of patients found with lung cancer are asymptomatic.
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