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Dr Melissa Johnson Underscores the Need for Lung Cancer Screening Guidance for Never-Smokers


Melissa Johnson, MD, program director of Lung Cancer Research at Sarah Cannon, discusses the need for increased lung cancer screening among patients who have no tobacco use history.

We currently do not have a system in place for screening never-smokers for lung cancer, explained Melissa Johnson, MD, program director of Lung Cancer Research at Sarah Cannon.


Is enough being done to identify patients who should be screened for lung cancer, including never-smokers?

We know that screening patients for lung cancers decreases the number of patients being diagnosed with lung cancer each year. The problem is that the [National Lung Screening Trial] data is not always generalizable to all patients. You mentioned the never-smokers. It's a really good question. We don't have a mechanism for screening never-smokers. Just in 2021, we have decreased the number of pack-years required from 30 pack-years to 20 pack-years and decreased the age from 55 to 50 for patients to make them eligible for screening. And so those are steps in the right direction. But we'll never get to never-smokers if we're just looking for patients that have a tobacco screening history. In parts of the world such as Asia, 50% of lung cancer patients will be never-smokers. And so that shows us that our current ways of selecting patients (ie, their tobacco exposure history) are neither sufficient nor far-reaching enough to really be identifying those patients most at risk because they're not thinking about it.

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