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Lung Cancer Screening Guidelines

People who currently smoke or formerly smoked are at higher risk for lung cancer. The American Cancer Society recommends yearly lung cancer screening with a low-dose CT scan (LDCT) for some of these people.

Lung Cancer Screening Guidelines

The American Cancer Society recommends yearly screening for lung cancer with a low-dose CT (LDCT) scan for people aged 50 to 80 years who:

  • Smoke or used to smoke

AND

  • Have at least a 20 pack-year history of smoking

A pack-year is equal to smoking 1 pack (or about 20 cigarettes) per day for a year. For example, a person could have a 20 pack-year history by smoking 1 pack a day for 20 years, or by smoking 2 packs a day for 10 years.

Before deciding to be screened, people should have a discussion with a healthcare professional about the purpose of screening and how it is done, as well as the benefits, limits, and possible harms of screening.

People who still smoke should be counseled about quitting and offered interventions and resources to help them.

People should not be screened if they have serious health problems that will likely limit how long they will live, or if they won’t be able to or won’t want to get treatment if lung cancer is found.

Lung Cancer Screening Articles in
CA: A Cancer Journal for Clinicians

Guideline

Screening for Lung Cancer: 2023 Guideline Update from the American Cancer Society

This update of the 2013 lung cancer screening guidelines provides guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking.

Patient Page

Screening for Lung Cancer

This easy-to-read format summarizes the 2023 updated lung cancer screen guidelines.

Editorial

Lung Cancer Screening Guidelines: Smoking Matters, Not Quitting

Chief Patient Officer at the American Cancer Society Arif Kamal, MD, MBA, MHS, and CA editor Don Dizon, MD, confirm the need to expand the US population that’s recommended for lung cancer screening and the need to accelerate smoking cessation programs. 

A Systematic Review

Lung Cancer Diagnosis and Mortality Beyond 15 Years Since Quit in Individuals with a 20+ Pack‐Year History

The ACS Early Science Detection Science team oversaw this systematic review to better understand lung cancer incidence, risk, and mortality and found that people who formerly smoked remain at risk for lung cancer well beyond 15 years after they stop using tobacco and that the risks decline gradually. 

Lung Cancer Screening Articles in Cancer

A Simulation Modeling Study

Assessing the Impact of Increasing Lung Screening Eligibility by Relaxing the Maximum Years‐Since‐Quit Threshold

ACS researcher, Bob Smith, PhD, and others propose that expanding screening to people who formerly smoked, with more than 15 years since quitting (YSQ), would reduce deaths from lung cancer and increase life years, and that additional harms could be moderated by restricting recommendations to only those with reasonable life expectancy. 

Absolute Lung Cancer Risk Increases Among People with 15 Quit‐Years: Analyses to Inform the Update of the ACS Lung Cancer Screening Guideline

Authors suggest augmenting USPSTF eligibility criteria with people estimated to gain the most days of life (based on the LYFS-CT model of benefit from receiving lung cancer screening) could prevent lung cancer deaths more efficiently and fairly than relaxing the quit-year criteria.

Benefit‐to‐Radiation‐Risk of Low‐Dose Computed Tomography Lung Cancer Screening

Authors evaluate cancer risks due to ionizing radiation and find benefit-to-radiation-risk ratios are highly favorable for current low-dose computed tomography lung cancer screening. Their results emphasize the importance of using modern CT technologies, maintaining low follow-up rates, and minimizing both screening and follow-up radiation doses. 

Editorial

Time to Quit Using Quit Time as a Lung Cancer Screening Eligibility Criterion

Multiple lines of reasoning and evidence have converged to indicate that using the 15 years or less quit-years rule to determine lung cancer screening eligibility should be abandoned.

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