Here’s a startling fact: despite lung cancer being the leading cause of cancer death in the U.S., only one in five eligible adults underwent life-saving screening in 2024. But here’s where it gets even more alarming—this low screening rate means countless lives are at risk, as three times more lung cancer deaths could be prevented if everyone eligible were screened. According to a report published by the American Cancer Society (ACS) in JAMA on November 19, this gap represents a critical missed opportunity.
Lead author Priti Bandi, MD, the scientific director of cancer risk factors and screening surveillance research at ACS, expressed deep concern. ‘It’s disheartening to see such low participation in lung cancer screening,’ she stated. ‘What’s even more sobering is that this lack of engagement directly translates to preventable deaths.’
And this is the part most people miss: In the U.S., lung cancer is the second most common cancer, with 225,000 new cases and 125,000 deaths recorded this year alone. The U.S. Preventive Services Task Force (USPSTF) recommends annual low-dose CT (LDCT) screening for adults aged 50 to 80 with a 20 pack-year smoking history, whether they currently smoke or have quit within the past 15 years. Yet, despite these clear guidelines, screening rates remain shockingly low.
Using data from the 2024 National Health Interview Survey, Bandi’s team found that only 18.7% of the 12.8 million eligible individuals were up to date with their screenings. Of these, 55% were male, 66.4% were aged 60 or older, and 82.4% were white. Here’s the controversial part: If screening rates were to reach 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 this potential.
Even more striking, the researchers calculated that if screening were expanded to include 28.1 million ever-smoking individuals aged 50 to 60—currently ineligible under USPSTF criteria—an additional 29,690 deaths could be avoided. Bandi argues, ‘Expanding screening eligibility, regardless of years since quitting, is not just warranted—it’s a matter of life and death.’
But here’s the question that sparks debate: Should we broaden screening criteria to include younger or less heavy smokers, even if it means potentially over-screening? Or should we focus on improving participation among those already eligible? Bandi urges, ‘We need to raise these screening numbers—lives depend on it.’
What do you think? Is expanding eligibility the right move, or should efforts focus on educating and encouraging those already eligible to get screened? Share your thoughts in the comments below.
For the full report, visit here.