Summary
New study shows counting smoking years, not cigarette amount, could catch more lung cancers and make screening fairer for veterans.
Doctors are looking at a new way to decide who should get screened for lung cancer. Right now, doctors use a method that counts “pack-years,” which means how many packs of cigarettes someone smoked each day multiplied by how many years they smoked. A new study suggests a simpler method: just look at how many years someone smoked, no matter how much they smoked each day.
Researchers studied almost one million veterans to test this idea. They found that using smoking years instead of pack-years would let many more people qualify for screening. In fact, eligibility would grow by about 30%. Even better, this new method would catch a lot more hidden cancers. Missed cancers dropped a lot, from over 13% down to under 4% in one part of the study.
The biggest winners from this change would be women, Black veterans, and Hispanic and Latino veterans. These groups often smoke fewer cigarettes per day but still smoke for many years. Because the old method focuses on amount smoked per day, it can miss people in these groups who are still at high risk. The new method fixes this problem and makes screening fairer for everyone.
Dr. Brendan Heiden, who led the study, shared these results at a major cancer meeting in 2026. He pointed out that lung cancer kills more people than any other cancer, yet only 15% to 20% of people who qualify for screening actually get it. He hopes this research will help change national screening guidelines.
Dr. Coral Olazagasti, another cancer doctor, said this idea makes screening simpler. She compared it to how doctors don’t overcomplicate screening rules for breast cancer or colon cancer. She believes lung cancer screening should be just as simple: if someone smoked for 20 years, they should qualify for screening, no complicated math needed.
