What is the likelihood of having lung cancer with a clear chest xray and normal blood work? Only real symptom is SOB but clear Echo 15 months ago

Not likely at 32. At 32, it's very unlikely that you have lung cancer. Especially if you have no weight loss, no sweats and are not coughing up any blood. If you smoke, you can further reduce your risk by quitting! There are many causes for shortness of breath, so talk to your doctor about any further evaluation you might need.
Depends on risk. Chest xrays are not good tests to rule out lung cancer and neither is blood work. But at 32 your risk of lung cancer is very low. Even a heavy smoking history would not increase your risk to the point that it was likely that you had it as a cause of shortness of breath.

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