PERSPECTIVE article
Front. Oncol.
Sec. Thoracic Oncology
Lung Cancer Screening with AI Can Discover Cures for Many Early Diseases. A Public Utility Can Make Sure It Happens
James L Mulshine 1,2
Bruce S Pyenson 3
1. Rush University, Chicago, United States
2. Rush University Medical Center, Chicago, United States
3. Milliman,Inc, New York, New York, United States
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Abstract
Many nations around the world are now implementing CT-based lung cancer screening. Growing evidence led the United States to require insurance coverage for LCS in high-risk individuals. Current CT scanners can obtain vast amounts of anatomic and quantitative information from the viscera of the chest cavity, and it has become evident that the CT images obtained from LCS contain additional health information, including information that enables the early detection of other major tobacco-associated diseases, such as coronary artery disease and emphysema. Chest CT screening is now being integrated with the use of AI tools, and such tools will be essential to organize and manage the complex screening workflow required to efficiently deliver this rapidly expanding service. A threat to realizing the health benefits of chest CT screening is the difficulty in aggregating sufficient numbers of CT images and clinical follow-up data for research purposes. Enabling access to clinical imaging and outcome data as a public utility may be essential in addressing bottlenecks to innovation to early chest disease management. The collections of chest CT images with clinical data that are being accrued for routine screening care could be repurposed with web-based strategies at low cost to enable a new range of strategic analyses and rapid AI tool development.
Summary
Keywords
Algorithm validation, artificial intelligence, Chest CT, Coronary artery calcification, Emphysema, Lung cancer screening, Public utility
Received
28 January 2026
Accepted
19 February 2026
Copyright
© 2026 Mulshine and Pyenson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: James L Mulshine
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.