A 70-year-old man saw his primary care clinician and expressed concern about his lung cancer risk after learning a friend had recently died of it. The patient had had an 80-pack-year history, and had quit 7 years previously. His physician ordered a screening chest computed tomographic (CT) scan, which demonstrated a spiculated 12-mm lung nodule that was new when compared with scans done previously for other reasons. This prompted a positron emission tomographic scan, which showed metabolic activity, raising the suspicion for lung cancer. He was referred to a pulmonary-nodule clinic.