Your questions about lung cancer screening, answered

Lung cancer is a disease in which abnormal cells grow out of control in the lungs. It is the leading cause of cancer death in the United States for both men and women. Smoking causes most cases, but people who have never smoked can get it too. Risk factors include cigarette, pipe, or cigar smoking; secondhand smoke; radon gas (the second leading cause after smoking); air pollution; workplace exposure to asbestos and other chemicals; and a personal or family history of lung cancer.

The American Cancer Society estimates about 229,000 new cases and about 125,000 deaths from lung cancer in 2026. It causes about 1 in 5 cancer deaths, more than colon, breast, and prostate cancers combined. About 1 in 19 Americans will be diagnosed with lung cancer in their lifetime.

Overall, about 3 in 10 people are alive 5 years after a lung cancer diagnosis, but stage at diagnosis changes the odds dramatically. When it is found before it spreads beyond the lung, 5-year survival is about 65%. Once it has spread to distant organs, it falls to about 10%. Only about 1 in 4 lung cancers is found at that early, localized stage. This is exactly why screening matters.

The people at highest risk are current and former smokers, especially those with a long or heavy smoking history. Other risk factors include radon in the home, workplace exposure to asbestos, arsenic, chromium, or diesel exhaust, a personal or family history of lung cancer, COPD, and long-term secondhand smoke exposure. Black men have the highest lung cancer incidence rate in the US.

Pack-years measure how much someone has smoked over their lifetime: packs per day multiplied by years smoked. For example, 1 pack a day for 20 years is 20 pack-years, and half a pack a day for 40 years is also 20 pack-years. Screening guidelines use a 20 pack-year minimum. Our pack-year calculator does the math for you.

Yes. About 10% to 20% of lung cancers occur in people who never smoked. These cases are often linked to radon, secondhand smoke, air pollution, workplace exposures, or family history. Current screening guidelines are based on smoking history, so people who never smoked should talk with their doctor about their own risk.

Yes. Black Americans, people with lower incomes, and people in rural communities are less likely to be diagnosed early, less likely to receive curative treatment, and more likely to die from lung cancer. Unequal access to screening is a major reason. That is why Oatmeal Health works with community health centers, hospitals, and health plans to reach the people screening misses today.

Radiologists report screening results using Lung-RADS, a scoring system from the American College of Radiology. Category 1 means no nodules or only harmless ones; category 2 means very low risk; category 3 means probably benign, with a follow-up scan in 6 months; and categories 4A, 4B, and 4X mean suspicious findings that need more testing. Category 0 means the scan was incomplete or needs comparison with older images.

A lung nodule is a small spot in the lung, usually smaller than 3 cm. Most are scars from old infections or other harmless causes. A nodule means your care team will keep an eye on it, not that you have cancer.

For screening scans, follow-up is guided by the Lung-RADS category, which looks at the nodule's size, type, and whether it has grown since your last scan. It may be a repeat low-dose CT in 3, 6, or 12 months, a PET scan, or for a small number of people, a biopsy.

A false positive is a finding that needs follow-up but turns out not to be cancer. In the National Lung Screening Trial, about 96% of positive results were not cancer. Lung-RADS, which radiologists use today, was designed to reduce false positives, and most are resolved with a follow-up scan.

Your doctor will refer you to a lung specialist or thoracic surgeon. Next steps usually include a PET scan and a biopsy. If cancer is confirmed, treatment may include surgery, radiation, chemotherapy, immunotherapy, or targeted therapy. Cancer found early is much more likely to be curable.

Yes. A screening scan can show things unrelated to lung cancer, such as emphysema, calcium in the heart arteries, or an enlarged blood vessel. Your radiologist notes anything important, and your doctor will tell you whether it needs follow-up.

AI helps at several points: finding eligible patients in health records, helping radiologists spot and measure nodules, estimating how likely a nodule is to be cancer, and keeping follow-up from slipping through the cracks.

No. AI is a support tool. A board-certified radiologist still reviews your scan, makes the decisions, and signs the final report.

It depends on the tool and the study. Research shows AI can help radiologists find nodules they might otherwise miss, but AI also flags things that turn out to be nothing. That is why it is always used with a radiologist, never instead of one.

Oatmeal Health has three products. LungIQ finds patients who likely qualify for screening but have not been screened. LungNAV calls those patients, explains screening, and connects them to their care team's scheduling staff. LungAI gives radiologists a 0 to 100 cancer risk score for each nodule, inside the viewer they already use. LungAI is investigational and not FDA cleared.

Several AI tools that detect and measure lung nodules are cleared by the FDA through the 510(k) pathway. Oatmeal Health's LungAI is investigational and not FDA cleared; it is being developed for a 510(k) submission.

It can help. Only about 1 in 5 eligible Americans has been screened. AI can find eligible patients in health records, make it easier to start the screening conversation, and help make sure referrals are followed up.