To identify patients for lung cancer screening, the USPSTF (the United States Preventive Services Task Force) recommended using criteria based on smoking status and age. Despite substantial breakthroughs in screening with low-dose computed tomography (LDCT), the cancer detection rate (1.1%) remained low, underscoring the need to look at ways to improve the current lung cancer screening strategy. The researchers sought to find clinical risk factors for lung cancer in an urban safety-net hospital for an outline. Researchers looked at the records of 2,847 patients who had LDCT lung cancer screening between March 1, 2015, and December 31, 2019. The demographics and medical history of the patients were gathered. The researchers utilized a bivariate logistic regression to assess lung cancer predictors. Researchers screening group comprised considerably more African Americans (38.2% vs 4.5%, P<.0001), obesity (32.7% vs 28.3%, P<.0001), and chronic obstructive pulmonary disease (COPD) (45.9% vs 5.0%, P<.0001) than the National Lung Cancer Screening Trial (NLST) sample. COPD (odds ratio [OR]=2.14, P<.0001) and a family history of lung cancer (OR=2.77, P<.0001) were the best predictors of lung cancer. Age (OR=1.04, P<.001) and pack-years (OR=1.01, P<.001) were not as predictive as age. In a screening cohort at the urban safety-net hospital, a diagnosis of COPD and a family history of lung cancer were the most predictive of lung cancer. Future research should have been considered whether including the extra risk variables improved the % of lung cancers found by screening.