Experts Debate Potential Harms of Lung Cancer Screening

Medical societies claim recent studies have overestimated risks, but not everyone agrees.

Published on Mar. 9, 2026

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A joint statement from three medical societies has sparked debate about the potential harms of lung cancer screening. The statement claims that recent studies have exaggerated the risks of downstream procedures and complications, as well as the false-positive rate and cancer risk from radiation exposure. However, some experts argue that the real-world data on screening harms is likely worse than what was seen in clinical trials, and that the statement may be missing the real reasons for low screening uptake, such as socioeconomic barriers.

Why it matters

Lung cancer screening has been shown to reduce mortality, but uptake remains low. Understanding the potential harms is crucial to ensuring the screening program is as safe and accessible as possible for eligible patients.

The details

The statement, led by Dr. Elliot Servais, criticized a 2024 study that found higher rates of follow-up imaging, procedures, and complications compared to the landmark National Lung Screening Trial (NLST). The authors argued the study relied on electronic health records that lack clinical context. However, the study's lead author, Dr. Katharine Rendle, defended the work, saying they did the best they could with the available data. Dr. Gerard Silvestri also noted that the NLST population was healthier than real-world screening patients. The statement also took issue with what it called a misrepresentation of the NLST's false-positive rate, arguing the 96.4% figure cited in some papers was actually the false-discovery rate. Finally, the statement criticized a 2023 study estimating 100,000 lifetime cancers from CT scans performed in 2023, saying the risk assessment tool used was flawed.

  • The joint statement from the medical societies was released in 2026.
  • The 2024 study on real-world screening harms was published two years prior.
  • The 2023 study on radiation-induced cancers was published the year before that.

The players

Elliot Servais, MD

A physician at Labey Hospital & Medical Center in Burlington, Massachusetts, and the lead author of the joint statement from the medical societies.

Katharine Rendle, PhD

An associate professor at the University of Pennsylvania in Philadelphia and the lead author of the 2024 study on real-world screening harms.

Gerard Silvestri, MD

A lung cancer specialist at the Medical University of South Carolina's Hollings Cancer Center in Charleston, South Carolina, who runs a large lung cancer screening program.

Kim Lori Sandler, MD

A radiologist who directs the lung screening program at Vanderbilt University Medical Center in Nashville, Tennessee.

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What they’re saying

“Despite challenges and limitations inherent in measuring outcomes in real-world practices, I stand by the strengths and rigor of our study.”

— Katharine Rendle, PhD, Associate professor, University of Pennsylvania (Medscape Medical News)

“If you're screening out in the community, they're older, they're sicker, compared with the NLST population.”

— Gerard Silvestri, MD, Lung cancer specialist, Medical University of South Carolina (Medscape Medical News)

“It's very, very unusual that we get a scan and we are so concerned that we immediately want to go to an invasive procedure like a biopsy.”

— Kim Lori Sandler, MD, Radiologist, Vanderbilt University Medical Center (Medscape Medical News)

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

This debate highlights the need for continued research and real-world data to ensure lung cancer screening is as safe and effective as possible, while also addressing the socioeconomic barriers that may be limiting uptake among eligible patients.