Here’s a startling fact: only one in five eligible U.S. adults underwent lung cancer screening in 2024, according to a report by the American Cancer Society (ACS) published in JAMA on November 19. But here’s where it gets even more alarming: this low screening rate means countless lives are at stake. Dr. Priti Bandi, the ACS’s scientific director of cancer risk factors and screening surveillance research, puts it bluntly: ‘It’s not just disappointing—it’s a missed opportunity. If everyone eligible were screened, three times more lung cancer deaths could be prevented.’
Lung cancer is the second most common cancer in the U.S. and the leading cause of cancer-related deaths. This year alone, 225,000 new cases were diagnosed, and 125,000 lives were lost. The U.S. Preventive Services Task Force (USPSTF) recommends annual low-dose CT (LDCT) screenings for adults aged 50 to 80 with a 20 pack-year smoking history, whether they currently smoke or quit within the past 15 years. Yet, despite these clear guidelines, screening rates remain shockingly low.
Dr. Bandi’s team analyzed data from the 2024 National Health Interview Survey and found that of the 12.8 million eligible individuals, only 18.7% were up to date with their screenings. Here’s the breakdown: 55% were male, 66.4% were 60 or older, and 82.4% were white. And this is the part most people miss: if screening rates reached 100%, an estimated 62,110 lung cancer deaths could be prevented over five years, and 872,270 life-years could be gained. At current rates, we’re only achieving a quarter of that potential.
But here’s where it gets controversial: What if we expanded screening eligibility beyond the USPSTF’s current criteria? The researchers suggest that if 28.1 million ever-smoking individuals aged 50 to 60—currently ineligible—were screened, an additional 29,690 deaths could be avoided. Roughly 30% of this benefit would go to those who quit smoking 15 or more years ago and have 20 or more pack-years. Is it time to rethink who qualifies for screening?
Dr. Bandi urges, ‘We need to raise these screening numbers. Expanding eligibility, regardless of years since quitting, could save lives.’ But is this a feasible solution, or are there risks to over-screening? We want to hear from you—do you think broadening eligibility is the answer, or are there other barriers to screening we’re missing? Share your thoughts in the comments below.
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