Lung cancer is the leading cause of cancer death for both men and women in the US and globally — affecting more people each year than breast and prostate cancers combined.1 As the most common form of lung cancer, non-small cell lung cancer (NSCLC) accounts for about 80-85% of all cases and includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.2
But there’s renewed hope with early lung cancer detection becoming increasingly more important as treatment evolves. Lung cancer screening, comprehensive genomic profiling (CGP), and advances in precision medicine have made it possible to find the disease earlier and identify potential genomic drivers of cancer to determine treatments that may be effective while ruling out others.
To learn more about these developments in lung cancer care and understand the risk factors for the disease, we spoke with Mary Pasquinelli, DNP, FNP-BC, CTTS. She’s a nurse practitioner of Pulmonary and Thoracic Oncology at the University of Illinois Health System and the director of the Lung Cancer Screening Program at the University of Illinois (UI Health).
Who is at risk of developing lung cancer?
“People who actively smoke or have a smoking history are at the highest risk,” says Pasquinelli. But she notes other risk factors as well:
A family history of the disease
Exposure to radon gas (the second-leading cause of lung cancer)3
Exposure to secondhand smoke, certain metals (chromium, cadmium, and arsenic), organic chemicals, radiation, air pollution, or diesel exhaust
Specific jobs like firefighting, military service, rubber manufacturing, paving, roofing, painting, and chimney sweeping
While these are the most common indicators, Pasquinelli says that anyone with lungs can get lung cancer, even if they don’t have any of the factors listed above.
“Some people who develop lung cancer have never smoked,” she says. “It is important to pay attention to your health, know your risk, and talk with your healthcare provider if you have concerns.”
How does lung cancer screening work?
Lung cancer screening uses a low-dose computed tomography (LDCT), which is a specialized CT scan that takes detailed pictures of the lungs. Pasquinelli describes the test as quick, painless, and noninvasive. It also uses a lower dose of radiation than a standard CT scan.
During the scan, a person lies on the CT table with their arms above their head. The table moves through the CT scanner while the detailed images are taken of the lungs. There are no needles, IVs, or contrast dyes. A radiologist will then review the scan and send the results to your healthcare provider, with many people receiving their results within a few days.4
Current guidelines for lung cancer screening state that people who meet the following criteria are encouraged to get an annual screening:
Are ages 50 to 80 years
Have a 20 pack-year smoking history (Pack-years = Packs smoked per day x number of years smoked)
Currently smoke cigarettes or quit within the past 15 years
If you think you or a loved one may be at risk of lung cancer, advocating for LDCT screenings early on is critically important as the first step in detecting and diagnosing lung cancer. “Annual screening is recommended for people who qualify,” Pasquinelli advises. “[It] helps healthcare providers identify changes over time and improves the ability to detect lung cancer at earlier, more treatable stages.”
Can you explain what CGP (aka biomarker testing) is?
Every cancer is different, and finding an appropriate treatment requires a full understanding of the genomic drivers of a person’s specific cancer, which can provide information about selecting the most effective treatments while ruling out others that may be unlikely to help.5
For people diagnosed with NSCLC, there is more than a 50% chance of having an actionable biomarker, a genomic alteration that can currently be targeted by FDA-approved treatments.6 Biomarker status can be identified through CGP, which looks broadly across a tumor's DNA for alterations that may be driving the cancer. This can help maximize the chances that providers match patients to the right treatment at the right time.
“Testing for these biomarkers helps the oncology care team understand how a cancer is likely to behave and which treatments are most likely to work,” Pasquinelli explains. “In short, biomarker testing helps move lung cancer care away from a one-size-fits-all approach and toward more personalized treatment based on the unique biology of each person's cancer.”
Because CGP results may help inform targeted treatment options no matter the stage of disease, Pasquinelli believes that, in most cases, it’s important for patients and their healthcare teams to wait to receive their CGP test results before moving forward with a treatment plan. “Starting treatment before these results are available may mean missing an opportunity to select the best treatment from the beginning,” she notes.
How can patients and caregivers advocate for CGP?
While CGP is becoming more common in lung cancer care, it’s still important that patients and their loved ones advocate for it early on.
“When speaking with your provider, you might ask: ‘Has my tumor been tested for biomarkers?’ ‘How will the results affect my treatment options?’ ‘Should we wait for the results before making treatment decisions?’” Pasquinelli says. “It is also helpful to ask for a copy of your biomarker testing results and have your healthcare team explain what they mean. Being informed and involved in the conversation can help ensure that treatment decisions are based on the most complete information available.”
What does the future of lung cancer treatment look like?
Despite the fact that approximately 229,410 people will be diagnosed with lung cancer in the US in 2026 alone,7 Pasquinelli is optimistic about the future of treatment. “Lung cancer screening can find cancer earlier, when treatment is more likely to make a meaningful difference in a patient’s outcomes,” she says. “At the same time, CGP helps ensure that patients receive the treatment that is best matched to their specific cancer.”
Pasquinelli is passionate about increasing awareness of both early detection through lung cancer screening and biomarker testing no matter the stage of a person’s disease. In doing so, she believes patients and their loved ones can be better equipped to advocate for and take proactive steps for their care.
“As a nurse practitioner who has spent decades caring for people with lung cancer, I have never been more hopeful about the future of lung cancer care,” she says. “The combination of early detection and precision medicine is transforming lung cancer care and giving many patients more options, leading to the potential for better outcomes and more hope than ever before.”
References
American Cancer Society. Cancer Statistics, 2026. March 2026. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.70043
American Cancer Society. What is Lung Cancer? January 2024. https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html
Riudavets, M., Garcia de Herreros, M., Besse, B., & Mezquita, L. (2022). Radon and lung cancer: Current trends and future perspectives. Cancers, 14(13), 3142. https://doi.org/10.3390/cancers14133142
National Lung Screening Trial Research Team. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. New England Journal of Medicine, 365(5), 395–409. https://doi.org/10.1056/nejmoa1102873
National Cancer Institute. Biomarker Testing for Cancer Treatment. Available at: https://www.cancer.gov/about-cancer/treatment/types/biomarker-testing-cancer-treatment#is-biomarker-testing-part-of-precision-medicine. Accessed on April 21, 2023.
Johnson M, et al. “My Patient Was Diagnosed With Nontargetable Advanced Non–Small Cell Lung Cancer. What Now?” Diagnosis and Initial Treatment Options for Newly Diagnosed Patients With Advanced NSCLC. American Society of Clinical Oncology Educational Book 38. 2018; 696-707. DOI: 10.1200/EDBK_201231.
"Cancer Stat Facts: Common Cancer Sites." Surveillance, Epidemiology, and End Results Program, National Cancer Institute, https://seer.cancer.gov/statfacts/html/common.html. Accessed 18 Jun. 2026.