Low-Dose CT Screening Can Catch Lung Cancer Early, But Participation Is Still Low

Lung cancer screening using low-dose CT scans entered Israel’s health basket in September 2025, but uptake remains low. The test is intended for smokers aged 60 to 75 with at least 20 pack-years of exposure, including current smokers and people who quit less than 15 years ago. It is quick, noninvasive, requires no contrast dye, and uses a low radiation dose.

Family physician Prof. Amnon Lahad, chair of the National Council for Family Health, said many eligible people avoid screening because they fear bad news, feel guilty about smoking, cannot easily get appointments, or worry about radiation. He argued that the low-dose exam offers meaningful benefit and that, while a full-dose CT would be more accurate, the current test’s benefit outweighs the harm. He said patients should use the rational argument that screening can find disease early and improve survival, noting that more smokers who are screened stay alive than those who do not get tested.

Pulmonologist Prof. Yochai Adir, head of the pulmonary department at Carmel Medical Center and a former head of the Israel Lung Association, said early-stage lung cancer usually causes no symptoms. When it does, signs can include chest pain that worsens with deep breathing, cough, and sometimes bloody phlegm. He said a U.S. study of annual low-dose CT in smokers showed more early diagnoses and about 20% lower mortality, and later European research supported those findings. U.S. guidelines first recommended annual low-dose CT for high-risk groups in 2013.

After screening, radiologists interpret the scan and the result is passed to the family doctor. Prof. Lahad said the LANG-RAD system helps determine how serious each finding is and what the next step should be, from repeating the scan in one or two years, to repeating it in six months, to referring the patient for lung specialist evaluation, biopsy, bronchoscopy, or surgery. Prof. Adir said Israel has also opened fast-track lung cancer diagnosis centers because some patients, even with metastatic disease, have waited 10 to 11 months from diagnosis to treatment. He also said CT screening can reveal smoking-related lung damage and signs linked to COPD, which shares smoking as a main risk factor and may increase lung-cancer risk, but such findings still require spirometry and clinical assessment. He urged smokers over 40 with cough, phlegm, or shortness of breath to be evaluated for COPD, and people over 50 to ask for a low-dose chest CT, which is available in the health basket from age 60. Lahad said the health system still lacks a national outreach program and called on eligible patients to request the scan from their family doctor.