Lung Cancer Screening and Smoking Cessation: Never Too Early or Too Late

With lung cancer being the leading cause of cancer mortality worldwide, clinicians are eager for interventions that improve early detection (1). Lung cancer screening with low-dose computed tomography (LDCT) is now being broadly implemented across the United States (2,3). This is driven by results from the National Lung Screening Trial (NLST), which demonstrated three fewer deaths from lung cancer for every 1000 high-risk individuals who underwent screening with LDCT for three years, compared with three annual rounds of screening with chest radiography (4). Guidelines from multiple organizations including the United States Preventive Services Task Force (USPSTF), the American Cancer Society, and others now recommend lung cancer screening for high-risk patients, with eligibility criteria that are largely based on the NLST criteria (5). Importantly, the Centers for Medicare and Medicaid Services (CMS) now covers the cost of LDCT for current or former smokers who are 55 to 77 years old, have at least 30 pack-years of tobacco exposure, and still smoke or quit within the last 15 years.

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