Why Is Lung Cancer Screening 4 Times Less Common Than Breast and Colorectal Screening?

Lung cancer remains the leading cause of cancer death worldwide. Unfortunately, many people, including some healthcare professionals, do not know that an effective early-detection screening method exists. For high-risk individuals with a long smoking history, annual low-dose chest computed tomography (LDCT) can detect early, treatable lung cancers. Despite this, screening participation remains extremely low.

On April 2, 2025, JAMA published a study showing that low uptake is driven not by avoidance of preventive healthcare, as often assumed, but by structural factors such as limited awareness, complex eligibility criteria, and access barriers.

A Striking Gap: Lung Cancer Screening Is 4 Times Less Common Than Other Cancer Screening

Researchers affiliated with Massachusetts General Hospital analyzed data from 28,483 people aged 50-79 with a smoking history . The data came from the US Centers for Disease Control and Prevention (CDC) 2022 Behavioral Risk Factor Surveillance System dataset.

• Lung cancer screening participation was only 17-18% .
• Yet among the same individuals, 65% had undergone breast and colorectal cancer screening.

This gap shows lung cancer screening rates approximately four times lower than those for other cancers .

What Does This Mean?

As lead author Alexandra Potter noted, these findings show that people eligible for lung cancer screening are not generally opposed to preventive healthcare. They participate in other cancer screening, undermining the hypothesis of "resistance to preventive healthcare."

Why Does Lung Cancer Screening Lag Behind?

Researchers identify several main reasons:

1. Complex Eligibility Criteria

Eligibility for breast and colorectal screening generally depends on age, whereas lung cancer screening involves detailed criteria for both age and smoking history. This makes assessing eligibility more difficult for patients and healthcare professionals.

2. Access Problems

Lung cancer screening generally uses low-dose computed tomography (LDCT), and centers offering it are not available everywhere. Difficulty accessing screening centersis a major barrier, particularly in rural and socioeconomically disadvantaged areas.

3. Limited Awareness

The study shows that many people lack sufficient information about lung cancer screening or do not know they are eligible. In contrast, public service announcements, health campaigns, and medical recommendations for breast and colorectal screening are much more widespread.

What Should Be Done for Public Health?

According to senior author Dr. Chi-Fu Jeffrey Yang, a solution requires collaboration among multiple stakeholders:

“As a society, we must work together to increase awareness of lung cancer screening and remove barriers facing high-risk individuals.”

Proposed Interventions:

• Simplify lung cancer screening eligibility algorithms in primary care.
• Systematically identify high-risk people through family physicians and pulmonologists.
• Establish digital navigation systems to refer eligible patients to screening centers.
• Create simplified information campaigns for people with limited health literacy.

Conclusion: The Evidence Is Here; It Is Time to Act

This comprehensive study strongly highlights the need to review public health policies to expand lung cancer screening . People are receptive to preventive healthcare; the challenge is ensuring that accurate information and services reach the right individuals.