Emphysema phenotypes and lung cancer risk
Currently, lung cancer screening is advised only for current smokers or ex smokers that have quit in the last 15 years with a 20-pack year smoking history. This study clearly states that lung cancer screening should be based on emphysema severity and location, not smoke density.
Conclusions:
Visual scoring of emphysema predicts lung cancer risk. The centrilobular phenotype is associated with the greatest risk.#LungDisease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657833/
I'm guessing recommending annual lung cancer screening once a year for the 480 Million+ People Estimated to Have COPD would overwhelm the system. It's the only reason I can think they would recommend screening for individuals who have less cancer risk than others.