For decades, lung cancer has cast a long shadow. It has frequently been associated with blame, anxiety, and loss, making many sufferers feel criticised or ostracised. This stigma has discouraged numerous people from seeking early screening, speaking openly, or remaining engaged with long-term care. Today, however, analysts believe the landscape is altering. Rapid advances in screening, therapy, and patient-centered imaging are redefining lung cancer as an illness that is becoming more treatable and, for many, controllable over time. 

A special edition of the Journal of the American College of Radiology, published by Elsevier in partnership with the American Cancer Society National Lung Cancer Roundtable (ACS NLCRT), describes this transition in detail. It demonstrates how radiology is evolving beyond simply detecting disease to become a driver of equitable care, enhanced experiences, and restored dignity for patients who have long faced stigma. 

The urgency is evident. Cancer remains the second biggest cause of death in the United States, with lung cancer accounting for the majority of cancer deaths. Projections for 2025 alone revealed 226,650 new lung cancer cases and 124,730 deaths. These data highlight the importance of early screening, clear communication, and stigma-free support systems. 

One of the most prominent themes in the special issue is a change from tracking the number of scans performed to assessing real-world impact across the care route. "Lung cancer screening has matured into a system of care," says co-guest editor Lisa Carter-Bawa, PhD, MPH. She emphasises that screening must not only expand in scope but also become "humane, coordinated, and equitable" so that every patient feels appreciated rather than criticised. 

This change is based on four basic elements. First, radiology is now serving as an integration point, linking prevention, tobacco cessation support, diagnostic testing, biomarker analysis, and survival care. Second, programmes are prioritising value above volume, which means that success is assessed not by the number of low-dose CT (LDCT) scans, but by equitable access, safe radiation doses, effective follow-up, and reduced injury. Third, experts focus on the human experience, acknowledging that stigma and "scanxiety"—the stress patients suffer while awaiting test results—can prevent continuing care. Fourth, epidemiology, or the study of how illnesses spread in groups, is being used to improve screening procedures so that the correct people are examined at the right time. 

The issue also delves into practical issues such as enhancing system operability, assisting regional centres, minimising radiation exposure, explaining biomarker testing in simple terms, and addressing cannabis usage among those undergoing screening. Importantly, multiple publications explain how high mammography participation among women can be leveraged to increase lung cancer screening, particularly among people who do not consider themselves to be at risk. 

Co-guest editor Ashley Prosper, MD, points out that successful outcomes are dependent on eliminating data gaps between radiology, primary care, and oncology. "Maximising this positive impact requires a combination of strategic multidisciplinary partnerships, effective communication, and informatics tools," the researcher explains. 

Julie Barta, MD, concurs: "Although we know that lung cancer screening improves early detection and reduces lung cancer mortality, there is still much work to do in understanding how we identify high-risk patients for screening and deliver high-quality care." 

Crucially, the contributors emphasise that reducing lung cancer stigma is inextricably linked to improved care. The idea is to replace silence and shame with understanding and hope." Lung cancer can be treated and survived. "Everyone and every patient deserves to know this," says Ella A. Kazerooni, MD, MS. Her message supports the broader need to make patients feel appreciated rather than blamed. 

As Dr Carter-Bawa puts it: "The question is no longer whether lung cancer screening saves lives—it does—but how we ensure that its benefits are realised broadly, equitably, and with dignity." Radiology, she contends, is well-positioned to lead this shift.