Pharmacists Can Advance Lung Cancer Screening Awareness in High-Risk Patients

As pharmacists are continuously integrated into multidisciplinary healthcare teams and perform more clinical tasks—including Medicare Annual Wellness Visits—understanding the screening recommendations that should be addressed is vital. One critical health measure that is often underreported in eligible patients is lung cancer screening. ¹

Lung cancer is still the nation’s leading cause of cancer-related death, largely because most cases are not detected until more advanced stages (eg, stage 3 or 4). Tobacco smoking remains the primary risk factor and contributes to roughly 85% of all lung cancer cases.²

Pharmacists’ Role in Closing the Lung Cancer Screening Gap

In our role as Clinical Pharmacy Specialists in the Medical University of South Carolina’s (MUSC) Tobacco Treatment Program, we work with an interdisciplinary team of providers offering tobacco cessation counseling, medications, and access to clinical studies. As part of our treatment approach, we work in close collaboration with the MUSC Hollings Cancer Center Lung Cancer Screening Program due to the importance of quitting smoking, remaining smoke-free, and screening eligible patients.

For every patient referred to our services, we ensure they have received a lung cancer screening within the past year, and if not, we will complete the screening criteria ourselves to see if they are eligible. This creates an opportunity for us as pharmacists to help ensure the care gap facing these patients is resolved.

Despite the expansion of the US Preventive Services Task Force's (USPTF) screening recommendation in March 2021, it was reported that only 18.2% of those eligible in 2022 were screened for lung cancer.² In comparison, a study published in April 2025 by researchers at Mass General Brigham found that use of breast cancer and colon cancer screening tools in those eligible for lung cancer screening was nearly 4-fold higher than use of lung cancer screening. The authors note that the data indicates that these eligible patients are open to preventative health screenings, but there is a need for increased awareness of lung cancer screening and increased access to lung cancer screening clinics.³

Why Lung Cancer Screening Matters

People who smoke cigarettes are in general 15 to 30 times more likely to get lung cancer and/or die from lung cancer, as opposed to those that do not smoke. ⁴ This risk continues to increase as the length of time and quantity a person smokes increases.

Early detection of lung cancer can help improve outcomes and is why screening is recommended in these high-risk patients. Early detection can be linked with an increased 5-year survival rate of 65% as compared to 10% in lung cancer cases diagnosed later.¹ Detection in early disease can also impact what treatments may be available. Often treatment of early disease may be successful with surgery alone, whereas treatment for late-stage disease may be a combination of surgery and intensive targeted therapies such as chemotherapy and radiation.

Who Should Be Screened for Lung Cancer

The USPSTF recommends screening for adults between 50 and 80 years of age who have a 20-pack-year (or greater) smoking history and are either current smokers or have quit in the last 15 years. In these patients, screening is generally recommended annually with low-dose computed tomography (LDCT). Screening can typically be discontinued when a patient has been smoke-free for greater than 15 years, has a new health condition limiting life expectancy, and/or has curative lung surgery.²

Pack-year history is a standard measure used to quantify a person’s lifetime exposure to tobacco smoke and a key criterion for eligibility for lung cancer screening. To calculate this measure, first you need to determine how many packs are smoked per day by the patient. Since a standard pack contains 20 cigarettes, you would take how many cigarettes they smoke per day divided by 20. You then take that number multiplied by how many years the patient smoked to calculate their pack-year history.

If a person's smoking habits have varied over time (e.g., they smoked more heavily for a period or quit smoking before), you would typically calculate the pack-years for each period and add them all up to get the lifetime total.

Screening is key to early detection. When lung cancer is diagnosed at an early stage, it is more likely to be curable.⁵ Determining what resources are available at your practice site and your role in screening is crucial. Online resources and shared decision-making discussion tools are a great place to start.

Helpful Patient and Provider Lung Cancer Screening Resources

The American Lung Association has a variety of lung cancer screening resources for patients and healthcare professionals. For more information:

• Visit Lung.org/lcscreening.
• Check out our Saved By The Scan campaign and take the lung cancer risk quiz.
• Call the Lung Cancer HelpLine at 1-800-LUNGUSA or connect with a specialist online.

The good news is, with continued education and awareness, the survival rate for lung cancer has increased by over 50% in the past decade.⁶ Greater involvement from pharmacists in tobacco treatment and referrals for lung cancer screening is key to building on this success and further reducing lung cancer mortality.

REFERENCES

1. State of lung cancer: Key findings. State of Lung Cancer | Key Findings | American Lung Association. November 3, 2025. Accessed November 19, 2025. https://www.lung.org/research/state-of-lung-cancer/key-findings.

2. Krist AH, Davidson KW, Mangione CM, et al. Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021 Mar 9;325(10):962-970. doi: 10.1001/jama.2021.1117. PMID: 33687470

3. Potter AL, Kothagundla S, Haridas C, Chang AEB, Sequist LV, Yang CJ. Preventive Health Care Use Among Adults Eligible for Lung Cancer Screening in the US. JAMA. 2025;333(18):1635–1638. doi:10.1001/jama.2025.2157

4. Lung Cancer Risk Factors. Center for Disease Control. Accessed November 19^th, 2025. https://www.cdc.gov/lung-cancer/risk-factors/index.html

5. Choi HK, Mazzone PJ. Lung Cancer Screening. In: Grippi MA, Antin-Ozerkis DE, Dela Cruz CS, Kotloff RM, Kotton C, Pack AI. eds. Fishman’s Pulmonary Diseases and Disorders, 6e. McGraw-Hill Education; 2023. Accessed November 14, 2025. https://accessmedicine.mhmedical.com/content.aspx?bookid=3242&sectionid=270613453

6. American Cancer Society. Cancer Facts & Figures 2025. Atlanta: American Cancer Society; 2025.