If you think you’re safe from lung cancer just because you’ve never touched a cigarette, think again. Every two minutes, someone in the United States receives a lung cancer diagnosis, and 10-20% of cases occur in those who’ve never smoked or smoked fewer than 100 cigarettes in their life [1] [2].
Still, in traditional doctor settings, lung cancer screening strategies and clinical guidelines have focused on higher-risk populations, particularly adults over age 50 with a significant smoking history (often defined as at least a 20 pack-year history) [3].
At the same time, lung cancer diagnoses are increasingly being observed in younger individuals, even as smoking rates decline [4] [5]. Environmental exposures, including air pollution and radon, an odorless gas that can accumulate in homes, are among the factors being studied as potential contributors [6].
This shift in lung cancer prevalence begs the question: What can be done to get ahead of a life-altering diagnosis?
To catch potential issues early, a low-dose chest CT (LDCT) scan can be invaluable. LDCT is a specialized imaging scan designed to detect early signs of lung abnormalities, including lung cancer, using significantly less radiation than a standard CT. It is specifically designed to identify lung abnormalities before they cause symptoms, providing a level of visibility into your health that traditional screenings simply cannot match. As such, LDCT holds promise for improving healthspan and lifespan.
In December 2025, Biograph added the LDCT to its Comprehensive Assessment for Black Tier members. This test isn’t a broad, one-size-fits-all screening. Think of it as a risk-informed evaluation based on a comprehensive assessment of age and both traditional and non-traditional risk factors. Screening may begin as early as age 25 for individuals with risk factors, and at age 40 for those without.
Learn when this type of imaging may add clinically meaningful insights to your prevention-focused care plan.
What is a Low-Dose Chest CT?
A low-dose chest CT (LDCT) is an imaging scan that uses computed tomography to create detailed pictures of the lungs while minimizing radiation exposure.
Unlike a standard chest CT, which may be used to evaluate symptoms or diagnose known conditions, LDCT is primarily used as a screening and early detection tool, especially for lung cancer.
In short, the LDCT identifies early lung cancer signals that can be monitored and contextualized by informed clinicians.
How is LDCT Different From a Regular Chest CT?
The differences in these tests largely comes down to radiation exposure, purpose, and clinical context.
A standard chest CT:
Uses higher radiation doses
Is typically ordered to evaluate symptoms or known lung health concerns
Is designed for diagnostic precision
A low-dose CT chest scan:
Uses significantly less radiation
Is optimized for screening and repeat use over time
Focuses specifically on detecting early lung abnormalities
A single LDCT delivers approximately 0.65 to 2.36 millisieverts (mSv) of radiation, compared to about 7 mSv for a standard chest CT [8] [9]. Because ionizing radiation can cause cellular damage, cumulative exposure is considered when evaluating the risks and benefits of repeat imaging. To provide context, the most recent mean effective dose of the LDCT offered at Biograph is 0.95 mSv.
Think about it this way: Screening tools should balance sensitivity (finding early issues) with safety (minimizing unnecessary exposure). The LDCT is designed to do both.
Who is the Low-Dose Chest CT Recommended For Today?
Current guidelines recommend low-dose CT for lung cancer screening in individuals at higher risk, primarily based on smoking history.
This typically includes:
Adults aged 50-80
People with a significant smoking history
Current smokers or those who have quit within the past 15 years
Remember: this is a risk-based strategy, not a universal recommendation. Screening may be recommended for those whose risk is high enough that the potential for early detection and improved outcomes outweighs the risks of false positives, follow-up, and radiation exposure.
What About Non-Smokers and Never-Smokers?
As mentioned, the proportion of lung cancer cases is increasing for individuals who have never smoked or who have had minimal exposure to tobacco. While it’s true that smoking cigarettes still drives about 90% of lung cancer cases annually, it’s certainly not the only cause of lung cancer [10]. Other risk factors include:
Environmental exposures, such as radon and air pollution
Occupational risks, including inhaled particulates
Genetic and familial predisposition
There is also growing attention around lung cancer in younger adults, particularly women under 65, who may not meet traditional screening criteria but are at risk to develop the disease.
At Biograph, eligibility for low-dose chest CT is determined through a broader clinical lens. In addition to age and smoking history, factors such as sex, environmental exposures (including radon and secondhand smoke), genetic risk variants, and family history are considered to help identify individuals who may benefit from earlier evaluation.
Current screening guidelines do not routinely include these groups, even as emerging evidence suggests there may be value in more individualized, risk-based assessment beyond smoking history and age.
Why Biograph Added Low-Dose Chest CT in December 2025
In December 2025, Biograph added the LDCT to its Comprehensive Assessment for Black Tier members and as an add-on for Core members.
This decision reflects a broader shift in preventive care: expanding beyond reactive diagnostics toward earlier, risk-informed detection.
Several factors informed this addition:
Increased recognition of lung cancer in non-smokers
Limitations of symptom-based detection (early disease is often silent)
The opportunity to identify risk earlier, when intervention may be more effective
At Biograph, LDCT is not used for broad, routine screening in all individuals. Rather, it’s considered selectively based on personalized risk factors.
Candidacy is determined through a pre-visit clinical evaluation
Risk assessment includes factors beyond smoking history
Consideration extends across both men and women, with attention to evolving demographic trends
Biograph has also lowered the age threshold for consideration in certain cases, reflecting emerging data and clinical judgment around earlier risk identification. Any requirement for ongoing surveillance screening is based on consideration of the individual's risk factor profile and the results of their initial LDCT screening examination according to standard guidelines
The Bottom Line: When To Consider LDCT
Low-dose chest CT represents an important evolution in preventive imaging: a tool designed to identify potential risk before symptoms appear and when intervention is still possible. That said, a LDCT isn’t necessary for everyone. But it may be worth discussing if you:
Have a history of smoking
Have a family history of lung cancer
Have known environmental exposures (e.g., radon)
Have occupational exposure to lung irritants
Have had prior incidental lung nodules
Are experiencing persistent or unexplained respiratory symptoms
Are seeking a more proactive, risk-based screening strategy
Remember, more testing doesn’t always provide more value. At Biograph, LDCT is not a standalone scan. It is part of a coordinated approach to early detection, designed to provide clarity, guide decisions, and support long-term health outcomes.
Common Questions About VO2 Max
What is a low-dose chest CT?
A low-dose chest CT (LDCT) is a specialized imaging scan that uses lower radiation than a standard CT to detect early lung abnormalities, including lung cancer, before symptoms appear.
Who should get a low-dose chest CT?
Low-dose chest CT is conventionally recommended for individuals 50 years of age and older with a high-risk smoking history; however, expanded screening criteria considers age, sex, environmental exposures (e.g. radon gas and occupational fine particulate and smoke exposure), as well as familial and hereditary risk factors.
How much radiation is a low-dose chest CT?
A low-dose chest CT (LDCT) typically delivers approximately 0.65 to 2.36 millisieverts (mSv) of radiation, compared to about 7 mSv for a standard chest CT. At Biograph, the mean effective dose offered is about 1 mSv.
Because LDCT is designed for screening and repeat use over time, it uses significantly less radiation, but even low levels of ionizing radiation can accumulate over time, which is why the risks and benefits of imaging are considered within the context of individual risk.
Can never-smokers get lung cancer?
Yes. Up to 20% of annual lung cancer cases occur in never-smokers or those who have smoked fewer than 100 cigarettes in their life [1] [2]. This may be associated with environmental, genetic, or other non-smoking-related factors.
Should younger adults consider lung CT screening?
Lung cancer is increasingly being observed in younger individuals, including those without a smoking history. Screening decisions should be based on individual risk factors, such as sex, environmental exposures (e.g. radon gas and occupational fine particulate and smoke exposure), as well as familial and hereditary risk factors, rather than age alone.
What happens if a nodule is found?
Most nodules are benign. Follow-up typically involves:
Monitoring over time with repeat imaging
Assessing growth and characteristics
Escalating evaluation only if findings are concerning
How often should you get a low-dose chest CT?
For high-risk individuals, LDCT is often performed annually. For others, frequency depends on age, genetic testing, imaging results, and other risk factors.
Is LDCT covered by insurance?
Coverage varies by plan. Many plans cover LDCT for those who meet established screening criteria. Outside that, coverage may be less likely.
About the Author
Dr. Michael Doney is Biograph’s Executive Medical Director, with over 20 years of experience leading clinical care and advancing a more proactive, data-driven approach to medicine.
Clinical References
American Lung Association. Key Findings. www.lung.org. Published 2024.
https://www.lung.org/research/state-of-lung-cancer/key-findingsCDC. Lung Cancer Among People Who Never Smoked. Lung Cancer. Published April 30, 2024.
https://www.cdc.gov/lung-cancer/nonsmokers/index.htmlAmerican Cancer Society. Lung Cancer Screening Guidelines. Cancer.org. Published 2018.
https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.htmlJuan Carlos Laguna, Tagliamento M, Matteo Lambertini, Hiznay J, Mezquita L. Tackling Non–Small Cell Lung Cancer in Young Adults: From Risk Factors and Genetic Susceptibility to Lung Cancer Profile and Outcomes. American Society of Clinical Oncology educational book/Educational book. 2024;44(3). doi:10.1200/edbk_432488
American Lung Association. Tobacco Trends Brief: Overall Tobacco Trends Brief. Lung.org. Published 2022. https://www.lung.org/research/trends-in-lung-disease/tobacco-trends-brief/overall-smoking-trends
CDC. Radon and Your Health. Radon. Published February 16, 2024.https://www.cdc.gov/radon/about/index.html
2026 Cancer Statistics Report: Lung Cancer Has Survival Gains, Yet Remains Top Cause of Cancer Death. Lungcancerstoday.com. Published 2026. https://www.lungcancerstoday.com/post/american-cancer-society-report-lung-cancer-shows-notable-improvements-in-survival-but-remains-top-cause-of-us-cancer-deaths
USPSTF. Lung Cancer: Screening. U.S. Preventive Services Task Force. Published March 9, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
Harvard Health Publishing. Radiation Risk from Medical Imaging. Harvard Health. Published September 30, 2021. https://www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging
CDC. Lung Cancer Awareness. Cancer. Published March 4, 2024. https://www.cdc.gov/cancer/features/lung-cancer.html
