Update on Lung Cancer Screening

Andrew R. Brownlee, MD; Jessica S. Donington, MD, MSCR


Semin Respir Crit Care Med. 2020;41(3):447-452. 

In This Article


We, now, have a series of randomized controlled trials supporting the mortality benefit of LDCT lung cancer screening. There is, however, a great deal of progress to be made in the widespread implementation of lung cancer screening. The national adoption remains below 5%. The is due in part to the challenges and infrastructure associated with implementation of complex screening program and in part to stigma, nihilism, and slow acceptance by patients and primary care physicians. The complexity of eligibility and requirements for shared decision making and smoking cessation services have impeded acceptance. There are currently nearly 94 million current or former smokers in the United States, so the costs associated with screening is high but effectiveness compares favorably to other cancer screening programs. The hope is that with the new resounding evidence from the completed NELSON trial, improving costs of screening, nation-wide adoption will continue to increase.