Smoking History and Lung Cancer Screening

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Lung Cancer Screening (LCS) is key to early cancer diagnosis, and early cancer diagnosis saves lives.¹ However, in 2024, more than a decade after LCS was initially recommended, up-to-date LCS prevalence among those currently eligible remained low; only 15.0% of eligible adults were up-to-date with recommended LCS nationally.²

The lowest LCS was generally found in Southern states, where there is both a relatively high lung-cancer burden and significant healthcare access barriers (e.g., health insurance coverage gaps; limited lung cancer screening capacity; increased distance to lung cancer screening facilities in rural areas) (Maps 1.7.1 and 1.7.2).

The American Cancer Society (ACS) updated lung cancer screening guidelines for adults at high risk for lung cancer in November 2023³ with the primary change being the elimination of number of years since quitting as an eligibility criterion. ACS now recommends yearly screening for lung cancer with a low-dose computerized tomography (LDCT) scan for people aged 50 to 80 years who: 1) smoke or used to smoke AND 2) have at least a 20 pack-year history (e.g., calculated by number of packs smoked per day multiplied by the number of years smoked) of smoking.¹