In brief
- Lung cancer was the most frequently diagnosed cancer worldwide in 2022, with almost 2.5 million new cases, and the leading cause of cancer death, with an estimated 1.8 million deaths.
- In the NLST, 3 annual rounds of low-dose CT reduced lung cancer mortality by 20.0% and death from any cause by 6.7%, against chest radiography.
- In NELSON, the 10-year rate ratio for lung cancer death in men screened with volume CT was 0.76, against no screening.
- The USPSTF recommends annual low-dose CT from age 50 to 80 for people with a 20 pack-year history who smoke or quit within 15 years.
- A 2022 Council Recommendation asks EU countries to explore lung cancer screening in a stepwise approach, starting with people at high risk.
Almost 2.5 million new cases and 1.8 million deaths in 2022
The GLOBOCAN 2022 estimates from the International Agency for Research on Cancer (IARC) put lung cancer first for incidence, at 1 in 8 cancers diagnosed worldwide (12.4%). It also caused 18.7% of all cancer deaths (Bray et al., CA: A Cancer Journal for Clinicians, 2024).
Adenocarcinoma, the histology reported in the pope’s case, has emerged as the predominant subtype in recent years, according to an IARC analysis published in The Lancet Respiratory Medicine in February 2025. In general, fewer than 5% of lung nodules turn out to be cancer, according to the American Thoracic Society, and a nodule that proves malignant is usually a sign of early-stage disease.
A 20.0% reduction in lung cancer mortality with low-dose CT in the NLST
The National Lung Screening Trial randomised 53,454 people at 33 US centres to 3 annual screenings with low-dose CT or single-view chest radiography. Participants were 55 to 74 years old, had smoked at least 30 pack-years and, if former smokers, had quit within the previous 15 years.
Lung cancer mortality was 20.0% lower in the low-dose CT group. Death from any cause was 6.7% lower (P=0.02).
A rate ratio of 0.76 for lung cancer death in screened men in NELSON
NELSON compared volume CT screening with no screening, a different control from the NLST’s radiography arm. It randomised 13,195 men and 2,594 women aged 50 to 74 and screened at baseline and at years 1, 3 and 5.5, with at least 10 years of follow-up.
In men, the primary analysis, the cumulative rate ratio for death from lung cancer at 10 years was 0.76 (P=0.01). The authors concluded on the trial as a whole:
“lung-cancer mortality was significantly lower among those who underwent volume CT screening than among those who underwent no screening.”de Koning et al., New England Journal of Medicine (2020)
Among the 2,594 women, a subgroup analysis, the rate ratio was 0.67, with a confidence interval of 0.38 to 1.14 that included no difference.
US eligibility from age 50, and a stepwise approach in the EU
The US Preventive Services Task Force (USPSTF) issued a grade B recommendation in March 2021 for annual low-dose CT in adults aged 50 to 80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years. Screening stops once a person has not smoked for 15 years, or when a health problem substantially limits life expectancy or the ability or willingness to have curative lung surgery.
In Europe, the Council Recommendation of 9 December 2022 on cancer screening cited preliminary evidence for low-dose CT. It asked countries to explore the feasibility and effectiveness of a programme, for instance through implementation studies, starting with people at high risk.
The Vatican reported on 14 October that the pope’s recovery was proceeding as expected.
Sources
- Source. Pope Leo recovering “as expected” after surgery and lung cancer diagnosis, Vatican says (2026-10-13). cbsnews.com
This article was produced independently by the Lung Summit editorial team, without industry funding or input.
