Decentralizing Pulmonary Screening for China's Aging Population: From Hospitals to Communities

China's aging population faces a growing burden of chronic respiratory diseases, straining the public health system. Despite the Healthy China 2030 plan's emphasis on prevention and early detection, systemic barriers, such as low public awareness, urban-rural disparities, fragmented screening models, and uneven specialist distribution, hinder effective pulmonary care for older adults. To address these challenges, a shift toward community-based strategies, including mobile low-dose CT (LDCT) screening units, is proposed. These units improve accessibility, especially in rural areas, while AI integration enhances diagnostic accuracy and telemedicine bridges specialist gaps. Strengthening local healthcare capacity through training, policy support, and coordinated care among community health stations, hospitals, and the CDC is critical. Community engagement further boosts participation and follow-up. Success will be measured by early diagnosis rates, reduced disparities, and cost-effectiveness. Aligning with Healthy China 2030, this integrated approach promises equitable, sustainable respiratory care for aging populations.