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Open Access
CC BY 4.0 · Semin Respir Crit Care Med
DOI: 10.1055/a-2701-9312
Review Article

Updates in Lung Cancer Screening: A Decade of Evidence

Authors

  • Lori C. Sakoda

    1   Division of Research, Kaiser Permanente Northern California, Pleasanton, California
    2   Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California

  • Louise M. Henderson

    3   University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
    4   Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina

Funding This work was funded in part by the National Institutes of Health under grants (grant nos.: R01CA212014, R01CA251686, R01CA263322, and R01CA285976).
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Abstract

In this review, we summarize recent evidence from approximately the last 5 years across the lung cancer screening (LCS) care continuum. First, we review the results from the NELSON trial, from the extended follow-up of other LCS randomized controlled trials (RCTs), and from a meta-analysis of RCTs. Together, these RCTs reported a 16% relative reduction in lung cancer mortality for low-dose CT (LDCT) LCS versus non-LDCT controls. Next, we summarize updates to clinical guidelines and recommendations around LCS in the United States, noting the current debate around the use of time since quit as an eligibility criterion. We also discuss the implementation of LCS focusing on the following areas: (1) global landscape, (2) selection criteria and approach, (3) LCS program structure, (4) shared decision making, (5) smoking cessation, (6) LCS uptake, (7) American College of Radiology Lung Reporting and Data System, (8) annual LCS adherence, (9) screen-detected findings and management, (10) incidental findings and management, and (11) disparities. Lastly, we highlight emerging data and considerations for personalized LCS and new technologies, with an emphasis on risk prediction models, biomarkers, and artificial intelligence. This review highlights the latest changes to LCS and the ongoing need to monitor and evaluate LCS as it diffuses into clinical practice across various real-world settings.

Keywords

lung cancer screening - review - randomized controlled trials


Publication History

Received: 31 July 2025

Accepted: 15 September 2025

Accepted Manuscript online:
16 September 2025

Article published online:
16 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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