Lung Cancer Screening Can Save Lives

We encourage all eligible smokers to get screened.

Lung cancer is the leading cause of cancer deaths among both women and men, but early detection has been proven to save lives. Yet, according to the American Lung Association, less than one-third (28.1%) of lung cancer cases nationwide are caught.  and nearly half (43.1%) of all lung cancers are not discovered until a late stage when the cancer has spread to other organs and the survival rate is about 10%. 

However, there is no need for adults to miss early detection and treatment, thanks to screening with low-dose CT scanning, which has been covered by Medicare and every major insurer since 2015. Despite its availability, most Americans who meet the criteria for screening are not being advised by their healthcare provider to get screened, leading to needless suffering and early deaths.

The sad fact is that, according to the Journal of the American Medical Association, fewer than 20% of Americans who qualify are getting screened for lung cancer. Compare that to breast and colorectal screening rates nationwide that exceed 70%. 

If every eligible current and former smoker were screened, more than 60,000 lung cancer deaths could be prevented over five years, according to the same JAMA study. So why are lung cancer screening rates so low? 

Who is eligible for lung cancer screening?

The U.S. Preventive Services Task Force has recommended that adults ages 50 to 80 with a 20-pack-year smoking history (who smoked a pack of 20 cigarettes daily for 20 years or an equivalent combination), and who currently smoke or quit within the past 15 years, be screened. The National Comprehensive Cancer Network and the American Cancer Society go further, recommending screening for these smokers no matter how long ago they quit.

Has your primary care physician asked about your smoking history? That’s the first step to getting screened for lung cancer. 

What’s behind low lung cancer screening participation?

The reasons are varied. Some worry that there is potential for false positives and with them, more invasive follow-up procedures, procedural complications and financial cost. Those risks are less than 10%, but the National Lung Screening Trial showed a 20% reduction in lung cancer deaths with low-dose CT, and I think that benefit clearly outweighs them.

Some patients also feel a combination of shame and ostracism about smoking, which our society does not see as an addiction the same way as alcohol, drugs or gambling. Smokers often feel judged for their inability to simply stop. Some are afraid to talk openly about their smoking habit, avoiding the tough conversation and anticipated “shame on you” attitude from their healthcare professional. As a result, some are driven to understate their smoking, leading to lung cancer deaths that might have been prevented with screening.

However, the failure to screen mostly lies with primary care physicians, who need to advocate for and recommend lung cancer screening according to the latest guidelines. A survey of 97 primary care providers in Southern California, published in the Journal of Thoracic Disease in 2020, revealed that nearly 30% of providers had never ordered a low-dose CT for an eligible patient, and only about 6% could correctly name the eligibility criteria for screening. In addition, according to a 2025 Mount Sinai study in the American Journal of Respiratory and Critical Care Medicine, half of primary care patients with a smoking history had incomplete documentation in their charts, and more than 40% were missing pack-year histories, making it nearly impossible for doctors to flag eligible patients. 

Primary care physicians must set the tone for an open conversation with their patients who smoke and encourage patients to be frank about their smoking history. Physicians should include reassurance that smoking does not mean certain lung cancer death and explain that a long-term smoker’s mortality rate will be reduced if the cancer is caught early through screening. On the flip side, if an eligible patient’s test is negative for cancer, that might induce the smoker to quit, realizing they “dodged the bullet” and have a chance to stay cancer-free.

Given the importance and efficacy of early detection and treatment in contrast to late-stage detection, the medical community needs to refer patients for screenings to save lives.

Testing is easy and effective. Physicians must prescribe it.

The case for lung cancer screening is stronger and the eligible population broader than at any point before. As frontline medical professionals, primary care doctors need to ask fully about smoking histories, inform patients about benefits and risks, and offer the scan to each patient who meets the prescribed criteria. Medical practices should build the same kind of systematic reminder into their workflow that already exists for breast and colon cancer. The tools to close this gap exist today. Now physicians must develop the habit of using them and prescribing this lifesaving test.