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However, enthusiasm is growing for screening people who have never smoked,123 partly because of the rising proportion of lung cancer diagnoses in this group.45 The enthusiasm is also fuelled by compelling observations from East Asia, where opportunistic screening has become commonplace in some countries, including Taiwan and South Korea, where hospitals have promoted CT screening, regardless of smoking history.678 Studies report CT screening detects numerous early stage lung cancers in people who have never smoked9 and remarkably high survival rates for these screen detected cancers.10 Screening proponents argue that these data are sufficient to presume that the 20% reduction in lung cancer mortality reported in randomised trials among people who smoke heavily1112 can be extrapolated to those who have never smoked

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