These criteria would capture around 7 million Americans. If we screened all of them, we’d save around 32,000 lives.

But a couple of new analyses, appearing in the Annals of Internal Medicine, raise some interesting questions. We’ll tackle them in order.

First- are these criteria too simple? We have a number of statistical models that can quite accurately predict lung cancer risk. Why not just screen the highest risk people?

In an analysis using data from a representative health survey, Li Cheung and colleagues found that there is a substantial population of individuals at relatively high risk of lung cancer who wouldn’t fit under the current guideline’s umbrella. Here's the risk for a hypothetical 60 year old with a 25 pack-year history but also with emphysema and a family history of lung cancer under various models.