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Lung Surgeon Explains New Lung Cancer Screening Guidelines


New lung cancer screening guidelines from the U.S. Preventive Services Task Force double the number of smokers eligible for annual scans. Lung cancer is the second most common cancer and the leading cause of cancer death in the United States. In 2020, nearly 230,000 people were diagnosed with lung cancer, and more than 135,000 deaths were caused by the disease. Lung cancer is often diagnosed at late stages, when it is most deadly. When detected early, lung cancer is treatable and can even be cured with surgery.

Washington University thoracic surgeon Benjamin Kozower, MD, MPH, explains the significance of the new lung cancer screening guidelines, the importance of getting screened and the options available for patients in the Lung Cancer Screening Program at Siteman Cancer Center.

Lung Cancer Screening Guidelines Explained

What do these new guidelines mean?

Dr. Kozower: The new guidelines expand the eligibility for lung cancer screening. They also conclude that screening is beneficial for people at high risk of developing lung cancer.

Who is eligible for screening under the new guidelines?

Dr. Kozower: Anyone between ages 50-80 years with a smoking history of at least 20 “pack years,” and either currently smoking or quit within the past 15 years. A “pack-year” means smoking a pack of cigarettes a day for a year or an equivalent amount.

Why is lung cancer screening so important?

Dr. Kozower: It’s so important because lung cancer is the number one cancer killer in the United States, and it actually kills more people than breast cancer, colon cancer and prostate cancer combined. For decades, there’s been very little we can do about it because most people present with advanced-stage lung cancer. For the last 10 years, lung cancer screening has been around, but it has only been approved and paid for by Medicare and other insurers for the last few years. That’s why there are more and more lung cancer screening programs.

The reason it’s so important is that lung cancer screening saves lives. You’re finding early lung cancers that are potentially curable when patients have no symptoms at all, as opposed to waiting until these cancers are more advanced and there’s much less we can do to help people.

Does expanding eligibility mean that more lung cancers might be caught earlier?

Dr. Kozower: Exactly. It gives us the ability to help more people.

This change is important because it expands the number of patients eligible for screening. The U.S. Preventive Task Force expanded the age range and reduced the smoking history – both criteria increase the number of people who will qualify for lung cancer screening.

Will this have a major impact in the St. Louis area?

Dr. Kozower: Absolutely. Expanding down to age 50 gives that many more people the opportunity to get screened. We do this at all Siteman locations, including in North County, which reaches an at-risk population. We’re able to reach more people throughout St. Louis and, ultimately, save more lives.

How does lung cancer screening work?

Dr. Kozower: It’s more than just the scan. It’s a program.

The biggest risk factor for lung cancer is smoking, so it makes a lot of sense to do what’s called primary prevention, where we see if we can help people quit smoking. Part of the program is a meeting with a tobacco cessation expert, to see if we can help you quit.

Our team will go through the benefits and risks of screening with you. Then you get your scan. The screening itself is a special type of chest CT scan.

If you are eligible for lung cancer screening, ask your primary care physician about screening or get screened at Siteman Cancer Center.


We have a significant number of patients who have entered this program. They are very likely to be cured from their lung cancers if detected early.

Lung cancer screening is actually more effective than any other cancer screening. It is more effective than even mammograms for breast cancer or colonoscopies for colon cancer. It’s important that we encourage people at high risk to do this screening.

What should I do if I am diagnosed with lung cancer?

Dr. Kozower: The program that you are screened at will help you with a referral to a lung surgeon. They will also help you quit smoking if you haven’t already. They will make a recommendation for you to see a physician. In our program, the next step after a positive screening test is to see a thoracic surgeon like myself.

To learn more about the Lung Cancer Screening Program at Siteman Cancer Center, please call 314-747-3046 or visit the Siteman Cancer Center website.

To make an appointment with a Washington University lung surgeon or refer a patient, please call 314-362-7260 or visit the Cardiothoracic Surgery website.