Reframing computed tomography-associated cancer concerns in lifesaving screening: keeping the focus on lives saved.

Abstract

Governments and health systems across the Americas are actively expanding access to lung cancer screening using low-dose computed tomography (LDCT). Our Viewpoint addresses renewed controversy surrounding cancer risks from CT radiation exposure, particularly in the context of LDCT lung cancer screening and early detection. While model-based projections of radiation-induced cancer risks offer useful insights, they risk overstating harm when divorced from real-world evidence of LDCT mortality benefit and safety profile, as well as from ongoing device and protocol refinements that have progressively reduced radiation exposure. Given the persistently low screening uptake and striking disparities in access among high-risk populations, overemphasis on projected risks may deter participation in the only validated screening intervention proven to reduce lung cancer mortality. We argue that the focus must remain on expanding access to high-quality LDCT screening and fostering clear, evidence-based communication that promotes informed decision-making, strengthens public trust, and advances health equity.