News | Lung Imaging | November 21, 2023

Lung Cancer Survival Rate Gains, Need for Increased Screening Highlighted in American Lung Association State of Lung Cancer Report

The American Lung Association’s newly-released ‘State of Lung Cancer’ report reveals improvement in survival rates for people of color, examines the toll of lung cancer state-by-state, and sheds light on lingering disparities and the urgent need for increased screening.

The American Lung Association’s newly-released ‘State of Lung Cancer’ report reveals improvement in survival rate for people of color, examines the toll of lung cancer state-by-state, and sheds light on lingering disparities and the urgent need for increased screening.

The American Lung Association’s newly-released ‘State of Lung Cancer’ report reveals improvement in survival rate for people of color, examines the toll of lung cancer state-by-state, and sheds light on lingering disparities and the urgent need for increased screening. Image courtesy: American Lung Association

November 22, 2023 — Lung cancer survival rates are improving for everyone, including people of color, according to the American Lung Association’s 2023 “State of Lung Cancer” report. Notably, the five-year lung cancer survival rate for people of color has increased by 17% in the last two years, helping close the health disparity gap. Excerpts from the news summary issued detailing the findings follows.

The organization’s sixth annual “State of Lung Cancer” report, issued Nov. 14, highlights how the toll of lung cancer varies by state and examines key indicators throughout the U.S. including new cases, survival, early diagnosis, surgical treatment, lack of treatment and screening rates. The report found that the lung cancer five-year survival rate increased 22% nationally to 26.6% from 2015 to 2019. In addition, the survival rate has increased at a faster pace among communities of color, so that it is no longer significantly lower compared to white individuals.

“Because of the incredible work of the lung cancer community, including non-profits, researchers and healthcare professionals, more people are surviving lung cancer. We are encouraged by the work being done to eliminate lung cancer stigma, increase lung cancer screening and improve lung cancer treatment,” said Harold Wimmer, President and CEO of the American Lung Association. Wimmer added, “However, while we have seen an improvement in lung cancer survival rates for people of color, more work needs to be done to address persistent health disparities. Overall, people of color who are diagnosed with lung cancer are less likely to be diagnosed early, less likely to receive surgical treatment and more likely to receive no treatment.”

The report also closely tracks lung cancer screening nationally and by state. Lung cancer screening with annual low-dose CT scans for those at high risk can reduce the lung cancer death rate by up to 20%. In 2022, only 4.5% of those eligible were screened. Some states, such as California and Wyoming, had screening rates as low as 0.7% and 1.0%. The best state in the country for lung cancer screening was Massachusetts at 11.9%.

Key Findings

The introduction to the new ALA report offers the following perspective: About every two minutes, someone in the U.S. is diagnosed with lung cancer, and every day, lung cancer takes the lives of more than 356 of our friends, neighbors and loved ones. But now there’s hope as more people in America than ever are surviving lung cancer. While the disease remains the leading cause of cancer deaths, over the past five years, the survival rate has increased by 22% nationally to 26.6%. Additionally, it has increased at a faster pace among communities of color such that it is no longer significantly lower compared to white individuals.

This year’s report also examines the lifesaving potential of lung cancer screening, which can detect the disease at an earlier stage when it’s more curable, and the importance of advancements in lung cancer research, which holds the promise for better treatment options.

Based on new research, in March 2021, the United States Preventive Services Task Force expanded its recommendation for screening to include a larger age range and more current and former smokers. This dramatically increased the number of women and Black individuals who are considered at high risk for lung cancer. Unfortunately, in 2022, only 4.5% of all those eligible were screened, noted the ALA report.

National Trends in Survival Rates, Early Diagnosis and Treatment

Close to 238,000 people in the U.S. will be diagnosed with lung cancer this year. The 2023 “State of Lung Cancer” report found the following national trends in survival rates, early diagnosis and treatment of the disease:

Survival Rate: Lung cancer has one of the lowest five-year survival rates because cases are often diagnosed at later stages, when it is less likely to be curable. The national average of people alive five years after a lung cancer diagnosis is 26.6%. Survival rates were best in Rhode Island (33.3%) and worst in Oklahoma (21.2%).

Early Diagnosis: Nationally, only 26.6% of cases are diagnosed at an early stage when the five-year survival rate is much higher (63%). Unfortunately, 44% of cases are not caught until a late stage when the survival rate is only 8%. Early diagnosis rates were best in Massachusetts (33.3%), and worst in Hawaii (20.3%).

Surgery as First Course of Treatment: Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread. Nationally, 20.8% of cases underwent surgery. Surgical treatment rates decreased by 4% in 2020, likely due to the impact of the COVID-19 pandemic on utilization of medical care.

Lack of Treatment: There are multiple reasons why patients may not receive treatment after diagnosis. Some of these reasons may be unavoidable, but no one should go untreated because of lack of provider or patient knowledge, stigma associated with lung cancer, fatalism after diagnosis or cost of treatment. Nationally, 20.6% of cases receive no treatment. Lack of treatment rates increased by 5% in 2020, likely due to the impact of the COVID-19 pandemic on utilization of medical care.

Health Disparities: The report also highlights that, while the survival rate for people of color increased significantly, people of color who are diagnosed with lung cancer still face worse outcomes compared to white individuals, including less likely to be diagnosed early, less likely to receive surgical treatment and more likely to receive no treatment.

Medicaid Coverage: Fee-for-service state Medicaid programs are one of the only healthcare payers not required to cover lung cancer screening for high-risk populations. The Lung Association analyzed lung cancer screening coverage policies in state Medicaid fee-for-service programs to assess the current status of lung cancer screening coverage for the Medicaid population and found that 49 states’ Medicaid fee-for-service programs cover lung cancer screening, and one program does not provide coverage.

Call to Action

The “State of Lung Cancer” report provides a state-specific understanding of the burden of lung cancer and opportunities to address this deadly disease. The summary introduction also notes that the report serves as both a guidepost and rallying call, providing policymakers, researchers, healthcare practitioners, as well as patients, caregivers and others committed to ending lung cancer by identifying where their state can best focus its resources to decrease the toll of lung cancer.

To this end, the report highlights that states must do more to reduce the burden of lung cancer and encourages everyone to help end lung cancer. In doing so, and as an organization focused on advocacy, the ALA urged persons to join the Lung Association’s efforts by asking members of Congress to co-sponsor H.R. 4286, the Increasing Access to Lung Cancer Screening Act, at Lung.org/SOLC.

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy and research. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to champion clean air for all; to improve the quality of life for those with lung disease and their families; and to create a tobacco-free future. It has earned a 4-star rating from Charity Navigator and is a Platinum-Level GuideStar Member.

More information: www.lung.org