Why screening for the deadliest cancer in the U.S. misses most cases

[question everything]

(snip)

Under current recommendations, people are eligible for screening if they are 50 to 80 years old and have a history of heavy smoking, either actively or in the past 15 years. But those guidelines exclude a large number of people who could have their cancer detected earlier, according to a new study published Thursday in JAMA Network Open, a peer-reviewed journal. The study indicated that of the roughly 1,000 patients treated for lung cancer at Northwestern Medicine, only one-third met requirements for screening. The researchers noted that women, minorities and people who never smoked were disproportionately excluded.

(snip)

If screening were made available for anyone between the ages of 40 to 85 years old, researchers estimate that nearly 94 percent of lung cancer cases could be detected, preventing at least roughly 26,000 deaths each year if even 30 percent of people got screened. “Lung cancer is the biggest cause of cancer deaths in this country,” Bharat said. “It kills more people than breast, colon and prostate put together.” He and other experts said the study’s findings highlight that the cancer should no longer be seen as just a smoker’s disease.

(snip)

Those who are eligible for screening should get a low-dose CT scan annually, according to the U.S. Preventive Services Task Force, an independent panel of medical experts who recommend screenings and services to keep Americans healthy. These scans, which are covered by insurance for people who meet the USPSTF screening requirements, use a much lower amount of radiation than conventional CT scans and have been shown to be able to detect early lung cancers, as well as other conditions, according to medical experts.

(snip)

Some symptoms to watch out for include:

A dry cough that doesn’t get better
Chest pressure
Unexplained weight loss
Coughing blood


https://archive.ph/L2alT#selection-439.0-455.339

[multigraincracker]

1. I had the scan. Insurance paid the 2grand bill.

[slightlv]

4. Doc has me down to get one of the screenings

after the first of the year... once the confusion of changing MA is over once again. I think it's a good thing. My x-rays have always come back okay, but a deeper scan can only be beneficial. I just wish it wasn't limited only to us smokers and/or former smokers.

[msongs]

2. no more chest x rays? nt

[bamagal62]

3. Of the 2 people I know

That had lung cancer and sadly passed away, neither one was a smoker. These scans could save many lives.

[erronis]

5. Be careful of thinking more screenings will improve mortality.

Siddhartha Mukherjee has written several articles (and books) about some of the effects of increased screening. His most recent is https://www.newyorker.com/magazine/2025/06/23/the-catch-in-catching-cancer-early.

I can't paraphrase very well, but from what I understand, giving screenings to people that are not of high risk may lead to false positives and unneeded procedures. The procedures can be more damaging than letting the disease run its course. The final determinants are Quality-of-Life, and life-span. And, I think, these are based on the individual rather than the society.

[KT2000]

6. She died of lung cancer

35 years after she quit smoking.
I am partial to believing that the creation of the chemical BCME when formaldehyde and chloride ions mix is probably causing a lot of the lung cancer (small oat cell) in people who did not smoke, especially women.
Radon is another culprit.

[no_hypocrisy]

7. My mother died of lung cancer.

Smoker for 35+ years. Went cold turkey for 20 years.

But she went in to have a pencil-dot-sized spot removed from one lung at Memorial Sloan Kettering. In one year, both lungs had freckles of cancer and it was terminal.

The tragedy was she didn't know b/c my father, a retired physician, intervened and told her doctor not to tell her; he'd tell her. But he didn't. And you know when you're dying. Mom was in the hospital in bed and her doctor came by. Mom grabbed her by her white lapels and shook her, demanding to know if she was dying. As Mom had less than a week left, the doctor admitted it.

My mother was left with less than a week to make choices. And boy, was she mad at our father.

[question everything]

8. I am sorry for your loss. This must have been hard on the whole family.

It used to be that doctors did not share details of illness but things have changed.

[no_hypocrisy]

9. More tragic: after my mother discovered that she had less than a week to live,

her husband/my father didn't allow her to decide her protocol. Again, behind her back, he ordered a morphine drip that allowed her to go into a coma in order to spare her the awareness of her final hours. (I'm conflicted about this as part of me believes Mom would have made the same choice, but Dad denied her the choice.)

Thank you for your sympathy.