Missing Millions · 2026 estimate

11.9 million Americans are missing their lung cancer screening.

They qualify. They haven't been screened. Low-dose CT finds lung cancer early, when it is most treatable. See the gap where you live, then share it.

14.5 millionadults qualify for screening under USPSTF 2021 criteria: ages 50 to 80, 20+ pack-years, smoke now or quit within 15 years

18.2%of eligible adults were screened nationally (American Lung Association, 2025)

1 in 9adults ages 50 to 80 qualifies for screening and hasn't been screened (estimate)

Sources: USPSTF 2021; American Lung Association, State of Lung Cancer 2025; U.S. Census Bureau Population Estimates 2025; CDC PLACES 2025. Modeled estimates; see methodology below.

The gap, state by state

Shade shows how many adults ages 50 to 80 are missing screening. Select a state.

California

1,104,700

missing lung cancer screenings (estimate)

Qualify for screening1,327,800
Screening rate16.8%
Adults 50 to 80 missing screening1 in 11

See California by county

Every state, ranked

Ranked by estimated missing screenings. Select a column to sort.


1California	1,104,700	1,327,800	16.8%	1 in 11
2Texas	993,200	1,128,600	12.0%	1 in 9
3Florida	865,900	1,056,000	18.0%	1 in 10
4New York	582,400	744,700	21.8%	1 in 11
5Pennsylvania	574,700	716,500	19.8%	1 in 8
6Ohio	502,900	622,400	19.2%	1 in 8
7Michigan	410,900	514,900	20.2%	1 in 9
8North Carolina	408,300	505,300	19.2%	1 in 9
9Georgia	407,600	486,400	16.2%	1 in 9
10Illinois	404,100	500,700	19.3%	1 in 10
11Tennessee	358,100	420,300	14.8%	1 in 7
12Virginia	290,800	356,400	18.4%	1 in 10
13Indiana	283,100	351,300	19.4%	1 in 8
14Missouri	267,700	331,300	19.2%	1 in 8
15New Jersey	266,400	342,900	22.3%	1 in 12
16Arizona	242,600	288,400	15.9%	1 in 10
17Kentucky	223,700	284,700	21.4%	1 in 7
18Wisconsin	221,600	281,900	21.4%	1 in 9
19Washington	214,900	255,200	15.8%	1 in 12
20Louisiana	213,900	257,700	17.0%	1 in 7
21South Carolina	213,100	262,400	18.8%	1 in 9
22Alabama	206,900	266,000	22.2%	1 in 9
23Minnesota	201,700	245,700	17.9%	1 in 9
24Massachusetts	200,400	273,800	26.8%	1 in 12
25Oklahoma	186,800	208,500	10.4%	1 in 7
26Maryland	178,700	221,200	19.2%	1 in 12
27Colorado	176,100	198,300	11.2%	1 in 10
28Oregon	153,200	173,900	11.9%	1 in 9
29Mississippi	142,800	167,500	14.8%	1 in 7
30Arkansas	134,800	161,600	16.6%	1 in 8
31Nevada	134,100	155,900	14.0%	1 in 8
32Iowa	124,500	152,600	18.4%	1 in 8
33West Virginia	107,700	127,300	15.4%	1 in 6
34Kansas	102,700	130,500	21.3%	1 in 9
35Connecticut	98,900	135,500	27.0%	1 in 13
36New Mexico	84,800	95,300	11.0%	1 in 9
37Idaho	63,600	76,000	16.3%	1 in 10
38Nebraska	62,000	81,200	23.6%	1 in 10
39Utah	60,600	69,700	13.1%	1 in 14
40Maine	60,100	79,500	24.3%	1 in 9
41New Hampshire	47,900	59,000	18.8%	1 in 12
42Hawaii	46,900	55,100	14.9%	1 in 11
43Montana	46,700	54,300	13.9%	1 in 9
44Delaware	37,400	49,400	24.3%	1 in 11
45South Dakota	36,500	44,700	18.3%	1 in 8
46Rhode Island	30,800	44,700	31.0%	1 in 13
47Alaska	30,100	34,800	13.5%	1 in 7
48Wyoming	25,100	27,800	9.7%	1 in 8
49North Dakota	24,300	30,800	21.1%	1 in 10
50Vermont	21,300	27,900	23.8%	1 in 12
51District of Columbia	11,600	15,600	25.3%	1 in 14

Methodology

How we estimate the gap

These are modeled estimates built entirely from public data. They are not counts of individual people and contain no patient information.

Step 1

Adults ages 50 to 80

County population ages 50 to 79, plus one fifth of ages 80 to 84.

U.S. Census Bureau, Population Estimates, Vintage 2025

Step 2

Local smoking rate

County current cigarette smoking, modeled by CDC PLACES from BRFSS survey data.

CDC PLACES 2025 release; Kentucky and Pennsylvania use the 2024 release

Step 3

USPSTF 2021 eligibility

One national factor (0.99) covers former smokers who quit within 15 years and the share with 20+ pack-years, scaled so the U.S. total matches about 14.5 million eligible adults.

USPSTF 2021 recommendation and published national estimate

Step 4

Minus those screened

Each state's share of eligible adults who were screened is removed, leaving the estimated number missing.

American Lung Association, State of Lung Cancer 2025

missing = adults 50 to 80 × county smoking rate × 0.99 × (1 − state screening rate)

What this estimate is

A directional, population-level estimate for planning and awareness.
Built the same way for every county and state, so places can be compared.
Refreshed every November for Lung Cancer Awareness Month.

What it is not

Not a count of individual patients, and not a substitute for registry or claims data.
County smoking rates are modeled and less certain in small counties. Estimates under 50 are shown as "fewer than 50"; others are rounded.
Former-smoker and pack-year shares are applied nationally, so local smoking history differences are not fully captured.

County pages also use age from Census population estimates, language from the American Community Survey 2020 to 2024, and Medicare fee-for-service low-dose CT claims (CPT 71271, 2024) by provider location.

Many of them are already your patients.

Oatmeal Health helps health systems and community health centers find, navigate, and screen the people who qualify, alongside the care teams you already have.

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