Low-dose CT lung screening (LDCT)

Annual low-dose chest CT (LDCT) screens current and former heavy smokers for early-stage lung cancer at an effective dose of roughly 1–2 mSv. The pivotal US National Lung Screening Trial (NLST) showed a 20 percent relative reduction in lung-cancer mortality versus chest radiography; the Dutch–Belgian NELSON trial confirmed a 24 percent reduction in men at 10 years. The 2021 USPSTF recommendation (Grade B) covers adults aged 50–80 with a 20 pack-year history who currently smoke or quit within 15 years. In Germany the Bundesumweltministerium issued the Lungenkrebs-Früherkennungs-Verordnung in July 2024, the G-BA passed the corresponding Richtlinie in June 2025, and roll-out as a statutory health-insurance benefit is expected from April 2026 for ages 50–75 who have smoked for at least 25 years with ≥15 pack-years and who currently smoke or quit within the past 10 years. Known harms include false positives, incidentalomas and overdiagnosis; structured Lung-RADS reporting limits unnecessary work-up.