Is it cancer?
Pope Leo XIV said on October 11th that doctors found a nodule in his lung “at a very early stage.” Surgeons in Rome will remove it this week.
Doctors find a lung nodule in about 1.6 million Americans a year, and more than 95% aren’t cancer. Most small nodules get a repeat scan or nothing. Surgeons operate when cancer looks likely. The Vatican hasn’t said whether he had a biopsy, so the pathology report after surgery will show whether it’s cancer.
Small lung cancers have good odds.
Two large trials studied early lung cancers 2 centimeters or smaller. Removing part of a lobe worked as well as removing all of it. Between 79% and 94% of patients were alive 5 years later.
Why don’t more Americans get screened for lung cancer?
Doctors diagnose only 24% of U.S. lung cancers while still confined to the lung. They diagnose about half after it has spread to distant organs, when 5-year survival is about 10%.
A yearly low-dose CT scan finds them sooner. In the National Lung Screening Trial, CT prevented 1 lung cancer death per 320 heavy smokers screened, compared with chest X-rays. The U.S. Preventive Services Task Force recommends the scan for adults 50 to 80 with at least 20 pack-years who smoke or quit within 15 years. Because the task force gave it a B grade, most private plans must cover it with no copay.
The scan is free, and only 18.2% of eligible Americans got one in 2022.
The health secretary appoints and can remove the panel that set that grade. The Supreme Court upheld that power in June 2025. Robert F. Kennedy Jr. named 8 new members, half the panel, in September.
What about people who never smoked?
We don’t know the Pope’s smoking history. At Northwestern University, a quarter of 997 lung cancer patients had never smoked. Only 35% met the screening criteria for a chest CT. Never-smokers have no screening recommendation, so insurers won’t cover a scan. The Environmental Protection Agency calls radon the leading cause of lung cancer in never-smokers. A home test kit measures it.
I’m part of an NYU Langone study that scans Asian women who’ve never smoked. On the first scan, 1.3% of the 1,000 women had lung cancer. The National Lung Screening Trial found 1.1% in heavy smokers. The NYU study doesn’t measure whether finding these cancers early saves lives.