Lung cancer screening has come a long way, but it also has a long way to go.
Advanced imaging technologies, AI-assisted procedures and evolving screening programs help providers identify suspicious lung nodules earlier and with greater precision than ever before. One of the biggest challenges in lung cancer care isn't technology but actually getting patients in the building to use it.
Lung cancer is by far the leading cause of cancer death in the U.S. for both men and women, yet only about 1 in 5 U.S. adults who are eligible for lung cancer screening actually get screened. But why?
Too many people, especially in small-town communities, still don't realize they qualify for screening, understand its benefits or recognize the importance of early screenings. As a result, lung cancer screening has yet to achieve the same level of public awareness as mammograms, colonoscopies or other preventive screenings.
As Lung Cancer Awareness Month approaches, healthcare organizations across the country are working to change that. In Fremont, Nebraska, one community has taken that mission personally.
The Overlooked Gap in Lung Cancer Screening
Despite established screening guidelines and advances in imaging technology, most eligible individuals still do not participate in screening programs.
That gap matters because lung cancer often develops without noticeable symptoms in its earliest stages: a persistent cough, mild shortness of breath, unexplained fatigue. And by the time symptoms become more noticeable, treatment options can become more complex. Screening offers an opportunity to identify concerns earlier, when intervention may be more effective.
Yet many eligible individuals remain unaware that screening exists, uncertain whether they qualify or disconnected from conversations about preventive lung health altogether.
The Life-Saving Power of Early Lung Cancer Screenings
In a late 2024 study, JAMA Oncology researchers looked at deaths from the most common causes of cancer mortality: breast, cervical, colorectal, lung and prostate.
"Although many people may believe that treatment advances are the major driver of reductions in mortality from these five cancers combined, the surprise here is how much prevention and screening contribute to reductions in mortality," said co-lead investigator Katrina A. B. Goddard, Ph.D., director of NCI’s Division of Cancer Control and Population Sciences. “Eight out of 10 deaths from these five cancers that were averted over the past 45 years were due to advances in prevention and screening.”
Lung cancer deaths were among the most averted because of prevention and screening; smoking cessation contributed to 3.45 million averted deaths from lung cancer alone.
Advances in imaging, navigation and biopsy technologies have also made it easier for a clinician to identify and evaluate suspicious nodules that may have been difficult to access or diagnose in the past. However, even the most advanced technologies cannot help patients who never enter the screening pathway.
That's why awareness remains such a critical component of improving outcomes. When eligible individuals understand the importance of screening and discuss their risk factors with healthcare providers, they are more likely to access potentially life-saving care before symptoms develop.
Why Lung Cancer Screening Falls Off the Radar
Unlike other preventive screenings that have benefited from decades of public education campaigns, lung cancer screening often remains outside routine healthcare conversations.
Several factors may contribute to this challenge:
For many communities, closing that gap requires more than clinical access. It requires local outreach, education and trusted healthcare organizations willing to bring the conversation directly to the people they serve.
Methodist Fremont Health Takes Action for their Community
Earlier this year, Methodist Fremont Health hosted a community event focused on lung cancer screening awareness and emerging diagnostic technologies. The event featured Intuitive Surgical's Thoracic Oncology Mobile Experience (TOME), highlighting the collaboration between Intuitive and Siemens Healthineers through the Ion Robotic Bronchoscopy System and Cios Spin imaging platform.
Patients, donors, healthcare professionals and community members had the opportunity to see firsthand how lung cancer can be detected and diagnosed.
Dr. Adam Wells, a pulmonary and critical care physician with Methodist Physicians Clinic and Methodist Hospital, said the goal was to close a screening gap that disproportionately affects rural communities.
“In the data that we have, rural Nebraska is massively under-screened, and their mortality rate is much higher,” he said. “So, the hope is by bringing it here to the community, we can catch it earlier, treat it faster and cure it sooner.”
Methodist Health System facility in Omaha already uses the Intuitive Ion Robotic System and Siemens Healthineers Cios Spin as part of lung cancer diagnostic workflows, and local leaders hope to bring that capability to Fremont in the future.
“Rural Nebraska is just so underserved in this scene, and so if we’re able to purchase this piece of equipment, it’s really going to save lives,” said Fremont Health Foundation Director Alli Greene.
For Greene and her team, the issue is also personal because of the people they serve.
"It's a small tightknit community, and so truly we're able to treat and see patients that we know and love," she said.
Dr. Michael Sanley, a pulmonologist at Methodist Fremont, was one of the clinicians at the event.
"It's been a gamechanger, to be honest with you," he said. "I'm doing biopsies now that I would have never dreamed about doing ten years ago without this technology."
Building a Stronger Future for Rural Lung Health
Whether it’s through community events like those provided by Methodist Fremont, provider education, patient outreach programs or investments in advanced technology, closing the screening gap requires long-term engagement from healthcare leaders and local advocates alike.
For healthcare organizations, providers, and community leaders trusted by their patient population, the opportunity to make a difference is greater than ever: continue investing in education, awareness and access so that more patients can receive care before symptoms appear.
Because in small-town communities like Fremont, an unscreened lung isn't just a statistic; it's someone you know.