Universal Age-Based Lung Cancer Screening: Expanding Horizons

Most lung cancers remain undetected at an early stage. A systems-level shift to universal age-based screening with low-dose CT (LDCT) is proposed to close that gap by capturing patients currently missed by risk-based surveillance—an urgent change to reduce avoidable, late-stage diagnoses.

Current surveillance anchored on smoking history reaches roughly 35% of those who develop lung cancer, producing a demographic skew that disproportionately excludes women and never-smokers. This narrow eligibility contributes directly to underdiagnosis and delays in initiating curative-intent therapy.

Broadening eligibility to ages 40–85 could raise case capture to about 94% and avert more than 26,000 deaths per year while remaining cost-effective and adding minimal procedural risk. Aligning lung screening with age-based population programs would shift stage at diagnosis toward earlier, more treatable disease.

LDCT also yields actionable ancillary findings—coronary artery calcification, emphysema, vertebral compression fractures and other chest conditions—that can trigger preventive or therapeutic steps. Advances in dose-reduction techniques, iterative reconstruction and AI-assisted interpretation have improved sensitivity and eased workflow. Embedding incidental-findings pathways into screening programs increases the overall clinical value of broader LDCT deployment.