Methods: The validated National Comprehensive Cancer Network Distress Thermometer(DT) was used to evaluate distress prior to and following lung cancer screening among 228 patients attending the Center for Lung Cancer Screening and Prevention at the Stony Brook Cancer Center between September 30, 2013 and September 29, 2014. Clinically significant distress was defined by a score≥4 on the DT instrument and logistic regression models were used to evaluate factors associated with high distress.