Cheung LC, et al. - In this cohort analyses and model-based projections of US population of ever-smokers aged 40 to 84 years, ie, 130,964 National Health Interview Survey individuals, representing about 60 million US ever-smokers during 1997 to 2015, researchers contrasted selection of ever-smokers for screening based on gains in life expectancy compared with lung cancer risk. Via the calibrated and validated mortality model in US ever-smokers aged 40 to 84 years and choosing 8.3 million ever-smokers to match the number chosen by the US Preventive Services Task Force criteria in 2013 to 2015, the analysis predicted that life-gained–based selection would raise the total life expectancy from CT screening, however, it would limit fewer lung cancer deaths (52,600 vs 55,000), in comparison with risk-based selection. The 1.56 million persons chosen by the life-gained–based approach though not the risk-based approach were younger and had fewer comorbidities. Hence, in the US population, by incorporating ever-smokers who have both high lung cancer risk and long life expectancy, life-gained–based selection could maximize the advantages of lung cancer screening.