Yong PC, et al. - An none of lung cancer risk models consider emphysema, a risk factor identifiable on baseline screen, researchers investigated the role of radiographic emphysema as an additional predictor of lung cancer diagnosis in participants with negative baseline low-dose CT (LDCT) screens of the National Lung Screening Trial. They analyzed their cohorts of participants with a negative baseline (T0) LDCT screen (n=16 624) and participants who subsequently had a negative 1-year follow-up (T1) screen (n=14 530), identifying an independent association of radiographic emphysema with nearly double the hazard of lung cancer diagnosis at both the second (T1) and third (T2) annual LDCT in all three risk models (the Bach, PLCOm2012 and Liverpool Lung Project models). Findings thus emphasize the independent predictive value of radiographic emphysema for lung cancer diagnosis and its significance in guiding decisions surrounding further screening for eligible patients.