Low Lung Cancer Screening Rates Persist Among Eligible Adults in US

Lung cancer screening rates among eligible adults in the United States remain critically low, with significant disparities across demographic groups, according to recent data. Despite recommendations from major health organizations, fewer than one in five eligible individuals underwent screening in 2024, missing a key opportunity to reduce lung cancer mortality, the leading cause of cancer death in the country.

Screening Rates Fall Short of Public Health Goals

A study published in the Journal of the American Medical Association (JAMA) on November 19, 2025, by the American Cancer Society (ACS) found that only an estimated 20% of eligible adults in the U.S. Received lung cancer screening (LCS) in 2024. The research, led by Dr. Priti Bandi, scientific director of cancer risk factors and screening surveillance research at the ACS, analyzed data from the 2024 National Health Interview Survey (NHIS), a nationally representative cross-sectional survey of non-institutionalized civilians.

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The findings underscore a persistent gap between public health recommendations and real-world screening uptake. The United States Preventive Services Task Force (USPSTF) and the ACS both recommend annual low-dose computed tomography (CT) screening for individuals at high risk of lung cancer, including current and former smokers with a significant history of tobacco use. However, the study revealed that 12.76 million individuals met the USPSTF eligibility criteria in 2024, yet only a fraction of them were screened.

“It’s disappointing that lung cancer screening uptake remains this low. More sobering is that this low uptake is translating into a real missed opportunity, as three times more lung cancer deaths could be prevented (or lives saved) if everyone eligible were screened.”

Dr. Priti Bandi, American Cancer Society

Missed Opportunities for Early Detection

Lung cancer is the second most common cancer in the U.S., with approximately 225,000 new cases diagnosed in 2025 and it remains the leading cause of cancer death, accounting for 125,000 deaths that year. Annual LCS has been shown to reduce lung cancer mortality by detecting tumors at earlier, more treatable stages. The ACS study estimated that increasing screening uptake to 100% among eligible individuals could triple the number of lung cancer deaths prevented and life-years gained.

Despite these potential benefits, screening rates have lagged behind those for other cancers. For comparison, breast, cervical, and colorectal cancer screening rates among eligible populations have consistently exceeded 60% in recent years. The disparity highlights systemic challenges in lung cancer screening implementation, including limited awareness among both patients and healthcare providers, barriers to accessing screening facilities, and persistent stigma associated with smoking.

Disparities in Screening Uptake

The 2024 NHIS data also revealed uneven screening rates across demographic groups. While the overall screening rate was 20%, uptake varied significantly by age, race, socioeconomic status, and geographic region. For example, individuals eligible under the 2021 USPSTF criteria—expanded to include adults aged 50 to 80 with a 20-pack-year smoking history—had lower screening rates (13.0%) compared to those eligible under the earlier 2013 criteria (21.8%).

These disparities reflect broader inequities in healthcare access and education. Populations with lower income, limited insurance coverage, or residence in rural areas were less likely to undergo screening. Racial and ethnic minorities, who may face cultural or linguistic barriers to healthcare, were underrepresented in screening programs.

Historical Context and Policy Efforts

The push for lung cancer screening gained momentum in 2013 when the USPSTF first recommended annual low-dose CT screening for high-risk individuals. At that time, screening rates were alarmingly low, with only 3.8% of eligible adults screened in 2010, according to data from the National Health Interview Survey. By 2020, screening rates had risen to 15.9%, and by 2022, they reached 21.8% among those eligible under the 2013 criteria. However, the expansion of eligibility criteria in 2021 to include a broader population did not translate into proportionate increases in screening uptake.

Public health initiatives, such as the Healthy People 2030 goals, have targeted a reduction in lung cancer deaths to 25.1 per 100,000 individuals. However, achieving this goal will require a substantial increase in screening rates. The 2015 NHIS baseline data, which reported a 4.5% screening rate among eligible individuals, informed the initial target of 7.5% by 2030. While progress has been made, the current 20% screening rate still falls short of what is needed to maximize the public health impact of LCS.

Barriers to Screening

Several factors contribute to the low uptake of lung cancer screening. One of the most significant is a lack of awareness among both patients and primary care providers. Many eligible individuals are unaware that screening is recommended or available, while some healthcare providers may not routinely discuss LCS with high-risk patients. Logistical challenges, such as the availability of screening facilities and the cost of low-dose CT scans, can deter individuals from pursuing screening.

Stigma surrounding smoking and lung cancer also plays a role. Unlike other cancers, lung cancer is often perceived as a self-inflicted disease, which can lead to feelings of shame or reluctance to seek screening. This stigma may be particularly pronounced among former smokers, who may avoid screening out of guilt or fear of judgment.

Efforts to Improve Screening Rates

In response to these challenges, public health organizations and healthcare systems have implemented strategies to increase lung cancer screening. These include:

• Public awareness campaigns to educate high-risk individuals about the benefits of LCS and the eligibility criteria.
• Provider education initiatives to ensure primary care physicians and other healthcare professionals are knowledgeable about screening guidelines and can effectively communicate them to patients.
• Policy changes to expand insurance coverage for LCS, including efforts to ensure that Medicare and Medicaid fully cover the cost of screening for eligible individuals.
• Community outreach programs targeting underserved populations, including racial and ethnic minorities, rural residents, and low-income individuals.

Despite these efforts, experts emphasize that more work is needed to close the gap between current screening rates and the goal of universal uptake among eligible individuals. Dr. Bandi and her colleagues at the ACS have called for a multi-faceted approach that addresses both systemic barriers and individual-level factors.

The Path Forward

The ACS study serves as a critical reminder of the urgent need to improve lung cancer screening rates. With lung cancer remaining the leading cause of cancer death in the U.S., the potential to save lives through early detection is substantial. However, realizing this potential will require concerted efforts from policymakers, healthcare providers, and public health advocates to overcome the barriers that continue to limit screening uptake.

As Dr. Bandi noted, the current screening rate represents a missed opportunity to prevent thousands of deaths annually. Closing this gap will not only save lives but also reduce the significant economic and emotional burden of lung cancer on patients, families, and the healthcare system.

For now, the message to eligible individuals is clear: lung cancer screening can save lives, and those at high risk should discuss their eligibility with their healthcare provider. Meanwhile, the broader healthcare community must redouble its efforts to ensure that screening is accessible, affordable, and widely promoted to all who stand to benefit.