Many individuals are unaware that lung cancer stands as the leading cause of cancer – related deaths in the United States. In fact, it claims more lives than colon, breast, and prostate cancers combined. According to a 2026 report by the American Cancer Society, three – quarters of people are diagnosed with lung cancer at an advanced stage, when treatment becomes more challenging.

Another worrying trend is that the incidence of lung cancer has been rising among younger adults, especially women, those of Asian descent, and individuals who have never smoked.

So, why isn’t there routine screening for lung cancer, similar to what exists for many other types of cancer? Here’s what the experts have to say.

Who currently gets screened?

The U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts in evidence – based medicine, recommends annual screening for lung cancer using a low – dose CT (computed tomography) scan only for select populations. This includes adults aged 50 to 80 years who have a 20 – pack – year smoking history and either currently smoke or have quit within the past 15 years. (A pack – year is defined as smoking one pack, approximately 20 cigarettes, per day for a year.)

However, some experts believe these guidelines should be expanded.

“The current guidelines for lung cancer screening are based on a very outdated risk – assessment model,” states Dr. Ankit Bharat, chief of thoracic surgery and executive director of the Canning Thoracic Institute at Northwestern Medicine. “It assumes that smoking is the sole cause of lung cancer. Those exposed to secondhand smoke, air pollution, or radon – well – established risk factors – have no means of getting screened.”

In a study published in the November 2025 issue of JAMA Network Open, Bharat and his colleagues examined the records of nearly 1,000 people treated for lung cancer and found that only 35% of them met the USPSTF screening criteria. The researchers estimate that if lung cancer screening were extended to include all people aged 40 to 85, it would detect 94% of lung cancers, preventing at least 26,000 deaths annually.

“People need to understand that not smoking does not make them immune to lung cancer,” says Bharat. “Early detection is the only way to treat early – stage lung cancer. Stage I lung cancer is completely curable, and treatment can be an outpatient procedure.”

“There’s no doubt that screening definitely saves lives, and early detection makes a difference,” says Dr. Roy Herbst, chief of medical oncology and hematology at the Yale Cancer Center.

Obstacles to lung cancer screening

Even within the current guidelines, most eligible individuals do not undergo screening. “The primary reason is the lack of public awareness,” says Dr. Samir Makani, medical director of the lung cancer screening program at the Scripps Cancer Center and an interventional pulmonologist at Scripps Memorial Hospital Encinitas. “Data shows that less than 20% of eligible people are getting screened. The responsibility for increasing awareness of lung cancer and the impact of lung cancer screening lies with all of us – patients, primary – care physicians, and the entire U.S. healthcare system.”

Part of the problem might be that the screening process is “cumbersome,” as Makani puts it. “For lung cancer screening, you need to have a shared decision – making visit with your doctor to discuss the risks and benefits, and then go for a CT scan.” In other words, it’s a two – step process, unlike simply getting an order for a mammogram or colonoscopy, for example.

One argument against expanding screening is that it would be too costly. Yet, Bharat points out that “the cost of treating someone with Stage I lung cancer is a fraction of the cost of treating Stage IV lung cancer.”

People are also concerned about radiation exposure from low – dose CT scans. “We don’t want to expose people to radiation unnecessarily,” says Herbst. However, the amount of radiation exposure is quite low – only slightly higher than that of a mammogram.

There are also concerns about incidental findings on these CT scans. “We may find things that aren’t lung cancer – it could be a benign lesion or a fungal infection causing a harmless nodule,” says Dr. Kim L. Sandler, a professor of radiology at Vanderbilt University Medical Center and director of the Vanderbilt Lung Screening Program. The possibility of incidental findings may worry some patients, but “incidental findings can be beneficial if they can be acted upon,” she notes.

Moreover, there’s another potential advantage to low – dose CT screening for lung cancer: A single scan can also assess heart and bone health by providing cross – sectional images of the entire chest cavity, including the heart and thoracic spine.

A push for universal lung cancer screening

Bharat believes that lung cancer screening should be universal for people over 40, regardless of their smoking history. Many other experts concur.

Sandler notes that with a universal approach, the interval for subsequent low – dose CT screenings would vary based on individuals’ personalized risk. “We have personalized screening recommendations for colon and breast cancer based on people’s risk factors,” says Sandler. “We need to figure out how to do the same for lung cancer.”

Until the screening recommendations are broadened, experts agree that people should be proactive about this issue. “If you’re eligible for screening, get screened,” Herbst says. “If you have a family history of lung cancer, discuss it with your doctor.”

Also, if you’ve ever smoked or had a previous cancer, especially breast cancer, make sure to discuss it with your doctor, Sandler says. And be sure to bring persistent symptoms like a chronic cough to your doctor’s attention.

While insurance coverage for low – dose CT lung cancer screening closely follows the USPSTF recommendations, your doctor may be able to secure coverage for you even if you don’t meet the criteria. A physician can make a clinical decision based on concerns about your lung cancer risk and may prescribe a CT scan or help you find an affordable option nearby if you’re paying out – of – pocket, Makani says. The out – of – pocket cost is often between $300 and $500, he adds.

“The most important aspect of lung cancer screening is the survival benefit,” says Makani. The five – year survival rate for Stage IA lung cancer is over 90%, he says, compared to 20% for Stage III. This is particularly significant, he adds, because “the majority of patients in whom we detect lung cancer are asymptomatic.”