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Related Experiment Video

Updated: Jul 1, 2026

Use of Electromagnetic Navigational Transthoracic Needle Aspiration E-TTNA for Sampling of Lung Nodules
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Published on: May 23, 2015

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Age-Based Screening for Lung Cancer Surveillance in the US.

Hee Chul Yang1, Austin Chang1, Maxime Visa1

  • 1Division of Thoracic Surgery, Canning Thoracic Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

JAMA Network Open
|November 20, 2025
PubMed
Summary

Current lung cancer screening guidelines miss many at-risk individuals, particularly women and never-smokers. Age-based screening significantly improves detection and is more cost-effective, addressing current guideline inequities.

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Area of Science:

  • Pulmonology
  • Oncology
  • Public Health

Background:

  • Lung cancer is increasingly diagnosed in never-smokers.
  • Current US Preventive Services Task Force (USPSTF) screening criteria may exclude at-risk individuals, raising concerns about effectiveness and equity.

Purpose of the Study:

  • Evaluate the proportion, characteristics, and survival of lung cancer patients meeting or excluded by USPSTF criteria.
  • Model expanded screening criteria and evaluate age-based screening.

Main Methods:

  • Analysis of lung cancer patients diagnosed 2018-2023 at an academic center.
  • Stratification by 2021 USPSTF eligibility (age 50-80, ≥20 pack-years, quit <15 years).
  • Modeling of expanded scenarios and benchmarking against breast and colorectal cancer screening.

Main Results:

  • Only 35.1% of 997 patients met USPSTF criteria.
  • The excluded group had more women, Asian patients, never-smokers, and adenocarcinoma diagnoses, with better survival.
  • Expanded criteria (age 40-85, ≥10 pack-years, no cessation limit) increased detection to 62.1%.
  • Modeled age-based screening (40-85 years) captured 93.9% of cases and was highly cost-effective.

Conclusions:

  • Current USPSTF guidelines exclude two-thirds of patients, disproportionately affecting women and never-smokers.
  • Age-based screening significantly improves lung cancer detection and addresses inequities.
  • Age-based lung cancer screening demonstrates superior cost-effectiveness compared to existing programs.