Fewer than 1 in 5 eligible Americans are getting recommended lung cancer screenings. Here's why.

Lung cancer is the deadliest form of cancer in the U.S., but new research shows that fewer than 1 in 5 people who are eligible to get screened for the disease actually do so. And while people were more likely to be up to date with lung cancer screening as they got older, only 1 in 20 people without insurance reported having screenings.

The study, which was published in JAMA Internal Medicine, analyzed data from the 2022 Behavioral Risk Factor Surveillance System, which is a nationwide survey. Among the nearly 26,000 people who were eligible for lung cancer screening, 61.5% said they currently smoked. Only 18.1% said they were up to date with lung cancer screening, although the levels varied by state (with fewer people in Southern states saying they were up to date).

“Early detection with lung cancer screening is critical because lung cancer symptoms often don't appear in the early stages,” Priti Bandi, scientific director of cancer risk factors and screening surveillance research at the American Cancer Society, tells Yahoo Life. “But when diagnosed and treated early, survival is markedly improved.”

So why aren’t more people getting screened? Doctors have a few theories — and explain why the process of lung cancer screening is nothing to be nervous about.

Why aren’t more people getting screened for lung cancer?

The study didn’t specifically look at why more people aren’t getting screened, but there are some theories.

A big issue is health care access, Dr. Jack Jacoub, a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, Calif., tells Yahoo Life. “There is no question that’s an issue,” he says. That can include people not having health insurance that will cover screenings, he points out. “That contributes to a lot of medical issues, and then people are only seeing physicians on an as-needed basis,” Jacoub says.

But some health care providers also may not be requesting that their patients get screened, he says. “Lung cancer screening is still relatively new in terms of recommendations,” Jacoub says. “It’s really only been around for a little over a decade.”

Jacoub also says that patients also may not be aware that lung cancer screening exists or that they’re eligible.

For those who are aware that this is an option and still choose not to get screened, it’s possible that they’re nervous about what screening would find, Dr. Tawee Tanvetyanon, a medical oncologist at Moffitt Cancer Center, tells Yahoo Life. “They should be reassured that lung cancer that is detected from screening tests is often [at a] very early stage,” he says. “It typically can be completely removed or ablated by pinpoint radiation.”

What does lung cancer screening involve?

Doctors stress that lung cancer screening is simple. It involves just three steps, Dr. Rohit Kumar, an associate professor at Fox Chase Cancer Center, tells Yahoo Life. That includes talking about eligibility with a health care provider, getting a computerized tomography (CT) scan and then discussing the results afterward.

The CT scan “takes under three minutes — no need to undress, no preparation, no contrast, no IVs,” Kumar says. Dr. Lary Robinson, a surgical oncologist at Moffitt Cancer Center, agrees that the process is simple. “The actual scan is performed in a single breath-hold,” he tells Yahoo Life. “Screening CT scans are virtually painless, very quick, and for almost all patients they are covered by insurance.” He also notes that the amount of radiation that people receive from these low-dose CT scans is “an insignificant risk.”

Who should get lung cancer screening?

The American Cancer Society recommends yearly screening for lung cancer for people between the ages of 50 and 80 who smoke or used to smoke and have at least a 20 pack-year history of smoking. A pack-year is equal to smoking one pack of cigarettes per day for a year. So people with a 20 pack-year history smoked a pack a day for 20 years, or smoked two packs a day for 10 years.

When should people be screened for lung cancer?

Lung cancer screening doesn’t just happen once. “People who meet the criteria for low-dose lung cancer screening should have a baseline scan and then follow-up screening CT scans for surveillance yearly,” Robinson says.

The current recommendations suggest that screening be stopped at 80, which Robinson says is controversial. “There is obviously a lot of controversy whether screening should stop at age 80, since so many individuals are in excellent condition nowadays when they reach 80 years old and can easily undergo treatment for an early-stage lung cancer when it is discovered,” he says. “I commonly surgically remove early-stage lung cancers in people over the age of 80 with very low risk, and patients recover very rapidly.”

Ultimately, Tanvetyanon says, “we still have room for improvement with the screening coverage.”

If you think you may need lung cancer screening but aren’t sure, contact your primary care physician. The doctor should be able to guide you. If you don’t have a doctor or health insurance, the American Cancer Society has a program to help you get screened for free.