Lung Cancer Screening Guidelines

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.

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

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. 

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. 

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. 

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.

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. 

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.