The American Cancer Society has expanded its annual screening guidelines for lung cancer to include younger former smokers regardless of when they quit.

The recommendations would make nearly 19 million eligible for yearly screening, up from 14 million under the previous guidelines, last updated in 2013.

Screening is now recommended for those between 50 and 80 with a pack-year history of 20 or higher, replacing guidelines that applied to those 55 to 74 with a 30-plus pack-year history.

It also eliminates the previous requirement that the person have quit smoking 15 years ago or less. Now, screening is recommended regardless of when they quit smoking.

“The rationale for this change is explained as follows: the individual risk of lung cancer does indeed decrease over time once someone quits smoking, but this reduction is relatively lower only if compared with a similar person who continues to smoke. Compared with a person who never smoked, the risk for lung cancer appears to remain three times greater, even at 20 and 30 YSQ,” according to an editorial in CA: A Cancer Journal for Clinicians accompanying the guidelines. “This introduces an entirely new cohort of people now eligible for lung cancer screening, some of whom we may not visualize when imagining the patient who should be contacted for annual screening.”

The recommended annual screening is a low-dose computed tomography scan (LDCT). Exempted from the screening recommendations is anyone with a health condition that significantly limits their life expectancy or their ability to be treated for lung cancer if diagnosed.

Lung cancer is the leading cause of cancer deaths among women and recently more young women than young men have been getting diagnosed, although many of those cases are in women who have never smoked.