A new study estimates that 26.4 million Americans aged 50–80 with a 20+ pack-year smoking history are eligible for lung cancer screening — yet fewer than 1 in 5 actually get screened. The research maps eligibility by race, age, and geography, spotlighting underserved rural and tribal communities. Closing this gap could save countless lives.
A new study published in Cancer offers the most detailed national estimate yet of who qualifies for lung cancer screening (LCS) in the US — and the numbers are striking. Using smoking prevalence data, census demographics, and a specialized Smoking History Generator, researchers calculated that 26.4 million Americans aged 50–80 have at least a 20 pack-year smoking history, making them eligible for low-dose CT screening. Of those, over 10.3 million are still actively smoking.
Despite this massive eligible population, LCS utilization remains below 20% nationally — a gap the researchers say stems partly from pack-year data being routinely missing from clinical records and health surveys. The new subpopulation estimates are designed to help health systems plan screening locations and allocate cessation resources more effectively.
By the Numbers:
Why it matters: Lung cancer is the leading cause of cancer death in the US, and early detection through screening dramatically improves survival. With millions of eligible individuals going unscreened — especially in rural, tribal, and minority communities — this data gives health systems a roadmap to target outreach where it's needed most.
