Only 18.7% of Eligible Americans Are Up to Date on Lung Cancer Screening, ACS Study Finds

Lung cancer kills more Americans than any other cancer, and the scan that catches it early goes largely unused.

An American Cancer Society (ACS) study published in JAMA used 2024 National Health Interview Survey data. It found that 12.76 million U.S. adults met federal screening criteria. Only 18.7% of them reported being up to date.

The researchers also put numbers on the gap. If every eligible adult were screened, about 62,110 lung cancer deaths could be prevented over five years, along with 872,270 years of life gained. At current screening rates, the projected benefit is about 14,970 deaths prevented and 190,030 years of life gained.

"It's disappointing that lung cancer screening uptake remains this low," said lead author Priti Bandi, Ph.D., ACS scientific director of cancer risk factors and screening surveillance research. "This low uptake is translating into a real missed opportunity, as three times more lung cancer deaths could be prevented."

The pope's diagnosis

Pope Leo XIV said on Oct. 11 that doctors had found a "small, localized nodule" in his lung during routine medical checks. He said it had been caught at a very early stage.

He underwent surgery two days later at Rome's Gemelli Hospital. Surgeons removed the lower lobe of his right lung. The Vatican said tests afterward confirmed lung adenocarcinoma, called the surgery successful and reported no complications. It said further tests on the removed tissue would provide more information in the coming days.

The Vatican has not said what kind of exam first found the nodule.

What the numbers look like

The ACS estimated about 225,000 new lung cancer cases and 125,000 deaths in the U.S. in 2025.

Coral Olazagasti, M.D., a thoracic medical oncologist at the University of Miami's Sylvester Comprehensive Cancer Center, put the overall five-year survival rate at around 29%. She attributes that to how many patients are diagnosed at advanced stages, when options are limited.

Daniel Boffa, M.D., a Yale thoracic surgeon and chair of the American College of Surgeons Commission on Cancer, says annual screening reduces the chance of dying from lung cancer by 20%. He says the share of eligible Americans who skip it adds up to "tens of thousands of preventable deaths every year."

Other cancers do far better. A separate JAMA study of 11,147 adults eligible for both breast and lung screening, using 2022 federal survey data, found about 65% had a mammogram. About 18% had a lung scan.

Another measure looks worse. Robert Van Haren, M.D., of the University of Cincinnati Cancer Center, led research finding that only 15% of eligible American adults have even discussed lung screening with their doctors.

Who qualifies

The U.S. Preventive Services Task Force recommends an annual low-dose CT scan for adults ages 50 to 80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years. A pack-year is packs per day multiplied by years smoked. One pack a day for 20 years equals 20.

That is harder to work out than eligibility for mammograms or colonoscopies, which turn mainly on age. Patients and doctors have to reconstruct decades of smoking history.

There is no set guideline for people who never smoked, though one in seven lung cancers occurs in that group. Boffa says never-smokers with a direct family history of lung cancer should consider annual scans, and he calls finding who else would benefit an "intense area of research."

Screening is not for everyone. The ACS says people with serious health problems likely to limit their lifespan should not be screened, nor should people who could not receive treatment if cancer were found. It also advises that anyone considering a scan first talk with a health care provider about the benefits, limits and possible harms. People who still smoke should be offered help quitting.

Symptoms come late

Lary Robinson, M.D., an oncologist at Moffitt Cancer Center in Tampa, says early-stage lung cancer usually causes no symptoms. When symptoms do appear, the most common are a persistent cough, shortness of breath or coughing up blood.

Van Haren made the same point about waiting. "People should not wait until they develop symptoms to think about lung cancer screening," he said. Adenocarcinoma is the most common type, about 40% of cases by his account, and it is often first spotted as a small nodule on a chest CT.

Boffa says fear should not stop people from getting checked. He is also looking ahead to an easier path. "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.

Until then, the test that exists is a single annual scan. Fewer than one in five of the 12.76 million Americans who qualify for it are getting it.