Lung cancer is the second most diagnosed cancer and remains the leading cause of cancer-related deaths in the United States. The high mortality is largely the consequence of late diagnosis; lung cancer is typically asymptomatic in early stages when a surgical cure is most likely. As a result, there has been great interest in and research on early detection of lung cancer through screening. There is evidence for reduced disease-specific mortality through screening for lung cancer. However, creating an integrated, systematic approach to lung cancer screening remains a challenge for providers. A successful lung cancer screening program weighs the benefits and harms of screening, clearly defines the target population and the screening process, and does not exclude eligible patient populations based on race, ethnicity, or socioeconomic status, In addition it should promote shared decision-making and address risk reduction.