Most Eligible Americans Skip a Lung Cancer Scan That Could Save Their Life

A Deadly Disease That Hides in Plain Sight

Many lung cancers can grow for years without causing any physical symptoms. No cough that won't quit, no chest pain, no obvious warning sign — just a disease quietly advancing while a person feels completely fine. That's what makes lung cancer so dangerous, and it's exactly why doctors are sounding the alarm about a widely underused screening tool that could change the odds dramatically.

Only 15% of eligible Americans get screened for lung cancer, translating to tens of thousands of preventable deaths every year, doctors warn. Dr. Daniel J. Boffa, chair of the American College of Surgeons Commission on Cancer and a thoracic surgeon at Yale University, noted that lung cancer screening is "one of the most powerful ways" to boost survival. The test itself is straightforward — and the potential payoff is enormous.

Who Qualifies and What the Scan Involves

The recommended screening test for lung cancer is a low-dose computed tomography scan, also called an LDCT. The U.S. Preventive Services Task Force recommends yearly lung cancer screening with LDCT for people who have a 20 pack-year or more smoking history, smoke now or have quit within the past 15 years, and are between 50 and 80 years old. A "pack-year" simply means smoking one pack per day for one year — so someone who smoked two packs a day for 10 years also meets that threshold.

Former smokers who quit within the past 15 years and had at least a 20 pack-year history likely still meet the criteria. Lung cancer risk gradually declines over time, which is why screening guidelines continue to include former smokers for up to 15 years after they quit. Because lung cancer screening is considered preventive care, many insurance plans are required to cover it at no cost, and most private health plans and Marketplace plans must cover a yearly low-dose CT scan without a copay or coinsurance, even if you have not met your deductible yet.

The Stigma Problem — and Why It's Outdated

Lung cancer screening rates are "still very, very low" when compared to other cancer screenings, like colonoscopy or mammograms, which see 70% to 80% of eligible people getting screened. Part of the gap comes down to fear and stigma. "People are really reluctant to be diagnosed with lung cancer because it does carry a stigma," Boffa said. "For years, there was a reputation that it was a terminal diagnosis. It's just been amazing what research has done for lung cancer."

Boffa noted that advances in lung cancer treatment have improved survival, even at advanced stages, so screening should not be viewed as a pathway to a terminal diagnosis. Survival rates improve significantly when lung cancer is found early, before it has had the chance to spread. The scan itself cuts the risk of dying from the disease by a significant margin — "It reduces the chance of people dying of lung cancer by 20%," Boffa said.

What About People Who Never Smoked?

Although one out of seven lung cancers will affect someone who has never smoked, there is currently not a set screening guideline for never-smokers. For now, people with a direct family history of lung cancer without smoking should consider annual screenings, as should higher-risk demographics like Asian women. Researchers are working to close that gap.

"I would anticipate that in the next year or two, we will have better guidance for people who are at risk for lung cancer, but never smoked," Boffa predicted. He also envisions a future where the process becomes even simpler: "I'm hoping that within four or five years, a screening CT scan will only be confirmatory after they have a positive blood test done at your doctor's office," he said — an approach that could make screening easier and potentially help detect more lung cancers. For now, the most urgent step is getting the people who already qualify to actually show up for the scan that could save their life.