Personalized lung cancer screening: Are we ready to ENGAGE?

Lay Summary The goal of delivering personalized lung cancer screening is a worthy one. It is inspiring to envision a future in which screening decisions are informed by the best available evidence, tailored to an individual's specific characteristics, and consistent with their preferences and values. At the societal level, tradeoffs between effectiveness, efficiency and equity are inevitable and will need to be balanced exquisitely, with ample input from patients and other stakeholders. Tools such as the ENGAGE framework will continue to enlighten and to shape the ongoing conversation. The vision for personalized lung cancer screening is compelling, but obstacles remain, and tradeoffs between competing goals are inevitable. Sophisticated decision tools such as the ENGAGE framework can potentially guide decisions by policy‐makers, population health managers and clinicians at the point of care.