These issues of policy aside, of greater concern are some of the prevailing views on lung cancer screening, even among eminent guideline organizations, that have quite seriously underestimated the potential number of lives saved and exaggerated the harms. The source of error regarding lives saved relates to a serious misinterpretation of the results of the National Lung Screening Trial (NLST). As its core result, NLST demonstrated a 20% mortality reduction in the CT scan screened arm of the trial compared with the chest radiograph control arm.4 This result has been mistakenly interpreted to mean that only 20% of those with potentially fatal lung cancer will be cured as a consequence of the screening. For example, in a joint statement from the American College of Chest Physicians and the American Society of Clinical Oncology based on that NLST result, the authors state the following to be included in a discussion between a physician and the person considering being screened: “4 out of 5 people who are going to die of lung cancer will die of it even if they are screened. Screening prevents one in five deaths from lung cancer.”5 The NLST result, however, is by no means a measure of the extent of lives that can be saved in the context of a sustained screening program. Instead, it was designed as a test of hypothesis about whether lives can be saved, and even more specifically, its primary intent was to determine whether there was an advantage to finding and treating smaller lung cancers diagnosed under CT scan screening compared with larger cancers diagnosed under chest radiography screening.6 As a test of that hypothesis, the NLST was successful; however, there has now been a misguided effort to transform that result into a measure of the magnitude of the benefit. Yankelevitz and Smith7 reported the two primary reasons inherent in stop-screen design trials, such as NLST, that cause the outcome measure of mortality reduction to be lower than the actual full magnitude of the benefit. The main point is that when addressing the magnitude of reduction in fatal outcomes of lung cancer that results from diagnosing the cancer earlier under screening, it is incorrect to equate this with the mortality reduction seen in a trial such as NLST with limited rounds of screening and limited length of follow-up. The mortality reduction within the NLST would have been very different with more screening rounds and different lengths of follow-up. In fact, there is nothing inherently incompatible between the 20% reduction in mortality reported in the NLST and the much higher estimates of cure rates for lung cancers diagnosed under screening, say even 70% to 80% as estimated by International Early Lung Cancer Action Program (I-ELCAP).8 Understanding this difference is critical to any decision-making process regarding coverage, and even more so in terms of providing information to a person interested in being screened. Therefore, these societies are obliged to correct their misrepresentation of this core result of the NLST.