Lung cancer screening

Screening & early detection

Why screen for lung cancer?

Screening looks for cancer in people who have no symptoms. The aim is to find a cancer earlier, when treatment may be more effective. Being offered screening does not mean your clinician thinks you have cancer.[1]

The recommended test is a low-dose computed tomography scan, or LDCT. It produces detailed pictures of the lungs using less radiation than a conventional chest CT. A chest X-ray is not a substitute for LDCT screening.[5]

A discussion about your risk

Who should consider screening?

A screening discussion is particularly relevant if you are 50–80 years old and have smoked for a total of at least 20 pack-years. Recommendations differ for people who stopped smoking more than 15 years ago, and insurance rules may be narrower than medical guidelines.[2][3][4]

Quitting smoking remains valuable even if you have smoked for many years. You do not have to quit before asking about screening, and screening does not replace support to stop smoking.[2]

If you have symptoms: a new or persistent cough, coughing up blood, or unexplained weight loss calls for a medical evaluation, rather than waiting for a routine screening appointment. People already being followed for lung cancer or a known nodule may need a different imaging plan.[2]

A brief, noninvasive examination

What is a low-dose CT scan like?

1. Before the scan

   The screening team reviews your history and the benefits and limitations of screening. Tell them where prior chest scans were performed so the images can be compared.

2. During the scan

   You lie on a table that moves through the scanner and briefly hold your breath. The scan is painless and does not require injected contrast dye or anesthesia.

3. After the scan

   Ask how and when you will receive your results, who will discuss them with you, and when your next scan should be scheduled.

The imaging portion is quick; allow additional time for check-in and preparation.[5][7]

The scan is the beginning of a plan

What happens after the result?

No concerning finding

Most people who remain eligible return for another screening scan in a year. A reassuring result does not mean future screening is unnecessary.[2]

A nodule needs a closer look

Many lung nodules are not cancer. Reviewing older images or repeating CT sooner may clarify whether a spot is changing.[5]

A more suspicious finding

A multidisciplinary team may recommend additional imaging, a biopsy, or surgical evaluation. The decision depends on the finding and your overall health; every nodule does not need an invasive procedure.[9]

If surgery is recommended, Dr. Servais uses robotic minimally invasive techniques in nearly all his lung operations, including complex cases. The choice and extent of surgery are individualized.

Putting the benefits and risks in perspective

Benefits and limitations

For appropriately selected people who meet screening criteria and are healthy enough to benefit from treatment, the expected benefits of annual low-dose CT screening substantially outweigh the risks. Screening can find lung cancer earlier and reduce the chance of dying from it. Experienced interpretation and a clear follow-up plan help preserve that benefit while minimizing unnecessary testing.[3][15]

Low radiation exposure

Screening CT uses a low dose of radiation. Even with repeated annual scans, the estimated additional lifetime risk of cancer from radiation is very small. For eligible patients, this risk is much smaller than the expected benefit of detecting lung cancer early.[13]

Low false-positive rates with modern screening

Modern protocols help keep false positives low. These are findings that require evaluation but prove noncancerous. Lahey reported rates of about 10% on initial scans and 5% on repeat annual scans, compared with 8%–10% for mammography.

Most follow-up involves reviewing prior images or repeating CT, rather than biopsy or surgery.[3]

Experience and multidisciplinary care at Lahey Clinic

Lahey Clinic’s lung cancer screening program has extensive experience and an established multidisciplinary team. Radiologists, pulmonary specialists, thoracic surgeons, and other clinicians work together to interpret findings, select the appropriate next step, and coordinate follow-up. The goal is to maximize the benefit of early detection while minimizing unnecessary procedures and their risks.[6][10]

In a published study of Lahey’s screening program, fewer than 1% of screened patients underwent an invasive diagnostic or treatment procedure for a finding that proved benign.[10]

Screening still has limitations: follow-up can cause worry, additional procedures have risks, and some detected cancers might never have caused harm. A normal scan also cannot rule out every cancer or replace evaluation of new symptoms. These limitations are part of an individualized discussion—not a reason to overlook the substantial benefit for eligible patients.[1][15]

Taking the next step

How to arrange screening

Start with your primary care clinician or a lung cancer screening program. Bring an estimate of your smoking history and, if applicable, the year you quit. Ask whether screening fits your health, how to obtain an order, and what your insurance covers.

Lahey Clinic has an established low-dose CT lung cancer screening program. Its program page provides contact information and details on getting started.[6]

Medicare covers annual screening for people who meet its criteria. Other plans may use different rules, and diagnostic tests after an abnormal result may have separate costs.[4]

Clinical practice, research & national service

Dr. Servais’s work in lung cancer screening

Dr. Servais’s academic work includes the evaluation of screen-detected nodules, surgical quality, and access to screening.

National screening leadership

He chairs the Society of Thoracic Surgeons Lung Cancer Screening Task Force and is the lead author of the STS expert consensus on interventions for screen-detected lung nodules. This work addresses the decisions and quality standards that follow an abnormal screening scan.[8][9]

Rescue Lung Society

He previously served as a founding board member of the Rescue Lung Society, an organization devoted to high-quality lung cancer screening and early detection. The society brings together professionals working to improve screening programs and follow-up care.[7]

Visit Rescue Lung Society ↗

Explore Rescue Lung Society’s screening resources. Some materials are intended for health professionals.

Selected publications

Research and clinical guidance

These publications include Dr. Servais as an author. The summaries below explain their focus; the articles themselves are written primarily for clinicians.

Questions to bring to your screening discussion

1. Do I meet screening guidelines, and does my insurance cover the scan?
2. How do my health and smoking history affect the decision?
3. Can my earlier chest scans be obtained for comparison?
4. Who will explain the result and arrange any follow-up?
5. When is my next scan due?

Sources & further reading

Patient resources appear first. Publication links below provide details about Dr. Servais’s research and national service.

Updated October 4, 2026. This guide supports a discussion with your care team. Screening recommendations and coverage may change, and eligibility should be reviewed individually.