Lung Cancer Screening Questionnaire

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The information provided through this questionnaire is intended for general educational purposes only. Results are not a substitute for professional medical advice, diagnosis, or treatment. Eligibility for lung cancer screening is determined by a qualified healthcare provider based on individual risk factors, medical history, and current screening guidelines. Completion of this questionnaire does not guarantee eligibility or insurance coverage for screening. * This field is required.I understand the above disclaimer and am ready to proceed with my questionnaire
YESNO
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Are you between 50 and 80 years old?* This field is required.
YESNO
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Have you smoked at least 20 pack-years in your lifetime?* This field is required.Calculate: AVERAGE # PACKS/DAY X TOTAL # OF YEARS SMOKED Need help calculating? Click this link: Pack Year Calculator
YESNO
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Do you currently smoke, or have you quit smoking within the past 15 years?* This field is required.
YESNO
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Do you have any health problems that substantially limit your life expectancy (e.g., under 10 years) or your ability/willingness to undergo curative lung surgery?* This field is required.
YESNO
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You May Be Eligible for Lung Cancer Screening

Based on your answers, you appear to meet current medical guidelines for low-dose CT (LDCT) lung cancer screening. Screening is used to detect lung cancer early—often before symptoms develop—when treatment options are most effective.

A final determination of eligibility and insurance coverage requires a clinical evaluation by a healthcare provider. Our team can review your results, confirm eligibility, and help you take the next steps if screening is appropriate.
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You Do Not Appear to Meet Lung Cancer Screening Guidelines at This Time

Based on the information you provided, you do not currently meet the recommended guidelines for low-dose CT (LDCT) lung cancer screening. This is common and does not mean that there is a health concern or that screening is never needed.

Screening guidelines are designed to identify individuals at higher risk. If your risk factors change in the future, or if you develop new symptoms or concerns, screening may become appropriate.

If you have questions about your lung health, a history of lung disease, or concerns about symptoms such as cough or shortness of breath, our team is available to help evaluate whether further testing is needed.
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