Lung cancer, once a devastating diagnosis, is now a disease that can be treated and survived. This powerful shift in the medical landscape is the focus of a special issue of the Journal of the American College of Radiology, published by Elsevier. The issue, a collaboration with the American Cancer Society National Lung Cancer Roundtable (ACS NLCRT), delves into the transformative role of radiology in lung cancer care.
For years, lung cancer has carried a heavy burden of stigma and fear. However, recent advancements in screening and treatment have brought a new hope and understanding. The special issue highlights how radiology is not just about detecting the disease but also about providing equitable, dignified care throughout the patient's journey.
Cancer's Impact: A Leading Cause of Death
Cancer remains a significant health concern, ranking as the second leading cause of death in the United States. Among all cancers, lung cancer stands out as the deadliest, claiming more lives annually than the next two leading causes of cancer death combined for both men and women. In 2025, the projected numbers were alarming: 226,650 new lung cancer cases and 124,730 deaths.
Transforming Radiology's Role
A key theme of the special issue is the shift from simply counting scans to measuring their impact on patient care. Lung cancer screening has evolved into a comprehensive system, focusing on equitable access, appropriate management, and holistic support for patients. The goal is to ensure that every patient, regardless of their setting, experiences screening with humanity, coordination, and fairness.
Core Principles for Transformation
The contributors to this issue identify four core principles driving the transformation of lung cancer screening and treatment:
Radiology as an Integrating Hub: Screening is now an interconnected service, with radiology bridging prevention, tobacco treatment, diagnostics, biomarker testing, and survivorship resources across different healthcare systems, reducing care fragmentation.
Value Over Volume: Success is not just about performing more LDCT scans but ensuring equitable access, appropriate follow-up, adherence to treatment, radiation stewardship, and minimizing potential harms.
Human Experience Matters: Anxiety about scans and results, coupled with the stigma associated with smoking history, can undermine patient trust and engagement. Programs that prioritize empathy, clear communication, and respect have been shown to improve patient involvement.
Refining Screening Targets: Using epidemiological studies to identify the right population for lung cancer screening is crucial. This ensures a balance between the benefits and potential harms of screening high-risk individuals.
Exploring Related Stories
The special issue covers a wide range of topics related to lung cancer screening, including eligibility requirements, strategies to increase participation, discussions on screening harms like "scanxiety," radiation dose management, and ongoing implementation challenges, such as system operability and rural collaboration.
Maximizing Impact and Changing Perspectives
Co-Guest Editor Ashley Prosper, MD, emphasizes the importance of multidisciplinary partnerships, effective communication, and informatics tools to maximize the positive impact of lung cancer screening. Closing data gaps between radiology, primary care, and oncology is crucial for timely diagnosis, appropriate follow-up, and equitable outcomes.
Co-Guest Editor Julie Barta, MD, highlights the need for further understanding in identifying high-risk patients and delivering high-quality care, despite the known benefits of early detection through screening.
The contributors stress the importance of a unified effort to dismantle the historical stigma and fear surrounding lung cancer. They advocate for a message of hope, emphasizing that lung cancer is treatable and survivable, and everyone deserves to know this.
Ella A. Kazerooni, MD, MS, Chair of the ACS NLCRT, adds, "Radiologists and their teams are integral to the medical community. Together with primary care clinicians and specialty colleagues, we can increase knowledge and awareness, replacing nihilism and stigma with empathy and hope for patients and their families."
Dr. Carter-Bawa concludes, "The question is not whether lung cancer screening saves lives - it does. The challenge is ensuring that these benefits are accessible to all, equitably, and with dignity. Radiology has a unique role to lead this charge."
This special issue provides a comprehensive look at the evolving landscape of lung cancer care, offering hope and a path forward for patients and healthcare professionals alike.
