What is the eligibility for government-funded lung cancer screening?

The Health Promotion Administration’s government-funded low-dose CT screening has two groups of eligible people: heavy smokers, and people with a family history of lung cancer. The age range and the conditions differ between the two, and smokers have additional conditions relating to stopping smoking. Each condition, and the upper and lower age limits, are adjusted as notices are revised, so follow the Health Promotion Administration’s latest notice and the explanation given by your hospital or clinic; the calculator on this page is for a first comparison only.

I do not smoke. Do I need lung cancer screening?

A substantial proportion of lung cancer in Taiwan occurs in people who have never smoked, and this is particularly marked in women, which differs from the epidemiology in Europe and the United States. Taiwan’s TALENT study screened people who had never smoked but had particular risk factors, above all a first-degree relative with lung cancer, and found that the detection rate for lung cancer was not low. People who have never smoked but have a first-degree relative with lung cancer are therefore an important group now included in government-funded screening.

Is the radiation dose from LDCT too high?

The radiation dose of a low-dose CT is about a quarter to a sixth of that of an ordinary CT of the chest, but it is still higher than a single chest X-ray. That is why it is used to screen groups with a clear risk, rather than being done by everybody, or every year. For those who meet the government-funded criteria, the interval advised is once every two years.

If screening finds a nodule, does that mean lung cancer?

The great majority of the time, no. LDCT is very sensitive and often finds small nodules, most of which are benign scars, traces of past inflammation or lymph nodes. The report gives a Lung-RADS category, which states the probability of malignancy and the follow-up advised; most need only regular follow-up to see whether anything changes, with no need for an immediate invasive test.

Are there any downsides to screening?

There are three main ones: false positives, which cause anxiety and lead to further tests; over-diagnosis (finding, and then treating, a cancer that would never have caused a problem in your lifetime); and exposure to radiation. These costs are real, which is why screening is advised only for groups whose risk is high enough for the expected benefit to outweigh the cost, rather than for everybody.

Find your symptom

Do I need lung cancer screening? In Taiwan, “I never smoked” is not a free pass

Division of Pulmonary Medicine, Taipei Veterans General Hospital Hsinchu Branch · Symptom triage

Three sentences first

In Taiwan, a substantial proportion of lung cancer occurs in people who have never smoked, and this is particularly marked in women — which differs from the epidemiology in Europe and the United States.
More screening is not better. It has clear costs: false positives, over-diagnosis, radiation. So it is advised only for groups whose risk is high enough.
A nodule that is found is very rarely a cancer. The report uses the Lung-RADS categories to tell you the probability of malignancy and how to follow it up, and most need only regular checks to see whether anything changes.

Why does Taiwan have to talk about lung cancer in people who do not smoke?

The international lung cancer screening trials (the NLST in the United States, NELSON in Europe) almost all studied heavy smokers, and showed that screening reduces lung cancer mortality. The situation in Taiwan is different: a high proportion of newly diagnosed lung cancer is in people who have never smoked, most of them women. Copying the criteria used abroad exactly would leave this very large group out of screening altogether.

The TALENT study: Taiwan’s own answer

Taiwan’s TALENT study used low-dose CT to screen people who had never smoked but had particular risk factors, the most important of which was a first-degree relative (parent, child or full sibling) with lung cancer. It found that the detection rate for lung cancer in this group was not low, and that the more affected relatives there were, and the younger they were when it began, the higher the risk.

This study is the main basis on which the Health Promotion Administration brought people with a family history of lung cancer into government-funded screening, and it makes Taiwan one of the few countries offering government-funded lung cancer screening aimed at people who have never smoked. Strong evidence

The two routes into government-funded screening

	Heavy smokers	People with a family history of lung cancer
Core condition	A cumulative amount smoked reaching a set “pack-year” threshold	A first-degree relative who has had lung cancer
Age range	There are explicit upper and lower limits	The lower limit differs for men and women
Additional conditions	Anyone still smoking must take part in a smoking cessation service at the same time; for those who have stopped, there is a limit on how long ago that was	Assessed on the number of relatives and their age at diagnosis
Frequency	For those who are eligible, once every 2 years

The conditions above are adjusted as the Health Promotion Administration revises its notices (the upper and lower age limits, the pack-year threshold and the years-since-quitting limit have all been revised before). Follow the Health Promotion Administration’s latest notice and the explanation given by your hospital or clinic. To work out your own eligibility exactly, use the government-funded eligibility tool in the clinical pathway section （中文）, which goes through the rules in force one by one and states the smoking cessation conditions that come with them.

The benefit of screening, and its real costs

The benefit: finding it while it can still be cured by surgery

Strong evidence

The great problem with lung cancer is that early on it causes almost no symptoms. By the time a cough, blood in the phlegm or weight loss brings someone to a doctor, it is often no longer early. LDCT can find a small lesion before there are any symptoms, and the cure rate for early lung cancer is vastly better than for late.

In heavy smokers, large international trials have shown that screening reduces lung cancer mortality.

Cost one: false positives

Strong evidence

LDCT is very sensitive and will find a great many small nodules, the great majority of which are benign — scars from old inflammation, lymph nodes, granulomas. But until that is confirmed, they bring anxiety and extra follow-up tests.

How to deal with it: the Lung-RADS classification system exists precisely to reduce unnecessary invasive tests. Do not panic at the word “nodule” — look at the category and the follow-up interval advised.

Cost two: over-diagnosis

Moderate

Some of the cancers that are found grow so slowly that they might never have caused a problem in a lifetime. But once one has been found, most people find it very hard not to treat it — and treatment has its own risks and costs.

How to deal with it: this is inherent in screening and cannot be wholly avoided. Its existence is one of the reasons that “screening is advised only for people at high enough risk”.

Cost three: radiation

Moderate

The radiation dose of a low-dose CT is about a quarter to a sixth of an ordinary CT of the chest, but it is still higher than a single chest X-ray.

How to deal with it: this is exactly why the interval advised is once every two years, rather than every year, and not for everybody. Do not pay for screening more often than that.

Government-funded LDCT and NHI-covered CT are two different systems

These two are often run together, but where the money comes from and what the conditions are differ completely:

The low-dose CT (LDCT) used for screening: paid for by the Health Promotion Administration’s government-funded screening programme, for people with no symptoms who meet the smoking history or family history conditions, once every 2 years. Government-funded (HPA)
Diagnostic CT of the chest: goes through the National Health Insurance (NHI). It requires a clear clinical indication, and the request has to state the clinical diagnosis, the purpose of the examination and the results of other relevant tests — which usually means a chest X-ray first that still does not explain things. Conditions apply

So “I am not eligible for the government-funded programme, so I will just have one CT on the NHI” does not work — the NHI does not pay for screening someone with no symptoms. If you still want it in that situation, it is self-paid.

Based on: the Health Promotion Administration’s chest low-dose computed tomography screening service programme; and the clauses on imaging examinations in the Points to Note in the Review of National Health Insurance Medical Expenses, National Health Insurance Administration, Ministry of Health and Welfare. Both are revised from time to time; follow the latest notices.

And after the report comes back?

An LDCT report usually uses the Lung-RADS categories. Their purpose is to turn “how likely is this nodule to be a cancer” into “what to do next”:

Category	Roughly what it means	What is usually done
0	The images are incomplete, or comparison with older ones is needed	Further imaging, or retrieving the older images
1 / 2	No nodule, or a clearly benign appearance	Simply carry on screening every 2 years
3	Probably benign, but stability needs confirming	Usually follow-up after 6 months
4A	Suspicious	Follow-up at about 3 months, or further imaging
4B / 4X	A higher probability of malignancy	Further diagnostic tests, which may include PET/CT, a biopsy or assessment for surgery

For the detailed rules on follow-up intervals and on nodule size and type (solid, part-solid, ground glass), use the post-LDCT follow-up tool （中文）.

Things that matter more than screening

Stop smoking. Screening finds it early; stopping smoking directly reduces the chance of getting it. The two are not in the same league — and the benefit of stopping starts to build from the first day. The National Health Insurance (NHI) funds smoking cessation clinics.
No smoking at all in the house. The effect of second-hand smoke on the people you live with, children and older people above all, is real.
Use the kitchen extractor hood, and make sure it is powerful enough. Fumes from high-temperature frying are one of the possible factors associated with lung cancer in women in Taiwan who do not smoke.
Do less vigorous outdoor exercise when air quality is poor, and keep the place ventilated when burning incense or joss paper.
If symptoms appear, do not wait for the next screening round. A cough that will not go away, coughing up blood, weight loss, hoarseness — these mean seeing a doctor straight away. Screening cannot take the place of being seen.

Common questions

I have a chest X-ray at my health check every year. Is that enough?

No. The chest X-ray has a very low sensitivity for early lung cancer — small lesions, and lesions hidden behind the heart or the diaphragm, are often invisible. Large international studies have already shown that screening for lung cancer with an X-ray does not reduce lung cancer mortality. If you are in a high-risk group, LDCT is the screening tool with the evidence behind it. That does not mean the X-ray is useless: in assessing symptoms (a cough, a fever, breathlessness) it remains an important first-line test.

The report says there is a “ground glass nodule”. Is that serious?

Not necessarily. A ground glass nodule (GGN) is an appearance on the image, and many are benign inflammatory change that disappears after a few months of follow-up. Some ground glass nodules that persist are indeed associated with early lung adenocarcinoma, but these lesions usually grow very slowly, so the standard approach is regular follow-up to watch for changes in size and density, rather than acting at once. Come back at the interval the report advises; do not arrange an invasive test earlier on your own, and do not let anxiety make you skip the follow-up.

I am not eligible for the government-funded programme. Should I pay for it myself?

It can be discussed, but understand two things first. One, the lower a person’s risk, the smaller the benefit of screening and the greater the relative cost of a false positive — that is a mathematical certainty. Two, self-paid screening will find nodules just the same, and they will need the same follow-up, so those costs have to be counted in too. Discuss your actual risk (family history, smoking history, occupational exposure) with a doctor first, then decide. If your risk really is on the high side and you simply do not meet the government-funded conditions, paying for it is a reasonable choice.

A member of my family has lung cancer. Does that mean I am bound to get it?

No. A family history raises the risk, but what it raises is the probability, not the certainty. That is also why screening is worthwhile: in a group whose probability is raised, the value of finding it early is greater. Taiwan’s TALENT study found that the more first-degree relatives affected, and the younger they were when it began, the higher the risk. Put together the ages at which your relatives were affected, and how many of them there were, and take that to clinic — it affects what screening is advised for you.

My screening was normal. How long before the next one?

For those who meet the government-funded criteria, the advice is once every 2 years. Every year is not advised — the radiation accumulates, and the benefit does not increase in proportion. But to be clear: one normal result does not mean there will never be anything. If a cough that will not go away, blood in the phlegm, weight loss or hoarseness appears between two screens, see a doctor straight away; do not wait for the next screening round.

What to do next

First work out your conditions exactly with the government-funded eligibility calculator （中文） (it goes through the rules in force and the smoking cessation conditions one by one), then bring the details of your family history (who, and at what age it began) to clinic to discuss.

Book an appointment with Dr. Hwa-Yen Chiu Work out government-funded eligibility （中文） Got a report? See the follow-up advice （中文）

References

衛生福利部國民健康署. 胸部低劑量電腦斷層檢查服務（115 年 1 月 1 日版）. 臺北：國民健康署. Available from: https://www.hpa.gov.tw
Christensen J, Prosper AE, Wu CC, et al. ACR Lung-RADS v2022: assessment categories and management recommendations. J Am Coll Radiol. 2024;21(3):473-488.
Taiwan Lung Cancer Screening in Never-Smoker Trial (TALENT). Lancet Respir Med. 2024;12(2):141-152.
National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409.
de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial （NELSON）. N Engl J Med. 2020;382(6):503-513.
衛生福利部中央健康保險署. 全民健康保險醫療費用審查注意事項——影像檢查相關條文；門診開立電腦斷層／磁振造影前之醫療影像調閱規定. Available from: https://www.nhi.gov.tw

References follow the ICMJE (Vancouver) style. Guidelines and official documents are given with their version or year of publication; legislation and National Health Insurance (NHI) rules are given with the responsible authority and the version date. Last checked: 8 October 2026.

Medical review

Medical author: Dr. Hwa-Yen Chiu
Chief of Pulmonary Medicine, Taipei Veterans General Hospital Hsinchu Branch
Last medically reviewed: 8 October 2026｜Dr. Hwa-Yen Chiu
Last updated: 8 October 2026
Intended readership: General public
Principal sources: Health Promotion Administration, government-funded LDCT service (version of 1 January 2026); ACR Lung-RADS® v2022; the TALENT study
Source types: Full texts of official guidelines, peer-reviewed literature on PubMed, and published rules from the Ministry of Health and Welfare and the National Health Insurance Administration

This page was written and reviewed by Dr. Hwa-Yen Chiu. Every treatment and test recommendation on this site carries an evidence grade, labelled separately from its National Health Insurance (NHI) coverage status. Guideline versions and coverage conditions are revised from time to time; what actually applies to you depends on the latest notices from the responsible authorities and on your own doctor’s judgement.

This content is health information. It is for reference only and cannot replace a professional medical diagnosis. Eligibility for government-funded screening follows the Health Promotion Administration’s latest notice, and the calculator on this page is for a first comparison only; all of the working is done on your own device, and your answers are not uploaded and are not stored. This site records only anonymous usage statistics (for example, how many people read this page to the end, how many complete a self-assessment, and which band the result falls into). It does not include what you answered, and it sets no cookies. See the privacy notice for details.

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