Lung-Cancer Screening with Low-Dose Computed Tomography

A 60-year-old woman comes for follow-up regarding essential hypertension. She has no symptoms other than mild, long-standing dyspnea on exertion; she specifically reports that she has no cough or chest pain and that her weight has not changed. There is no personal history of cancer or family history of lung cancer. She reports smoking one pack of cigarettes per day since 16 years of age. On prior visits, she declined assistance with smoking cessation, citing her stressful life situation as the primary caretaker for her disabled husband. Should you advise lung-cancer screening with low-dose computed tomography (CT)?