Lung Cancer Survival Improves in US

The national survival rate for lung cancer has increased by 26% in the past 5 years, to 28.4% of all cases, according to a new report from the American Lung Association.

Rates of preventive screening with low-dose CT, meanwhile, have remained low, at only 16% nationwide, even after the US Preventive Services Task Force broadened screening criteria in 2021 to include more younger patients and those with lighter smoking histories.

Just 27.4% of lung cancer cases in the United States are caught at an early stage, before cancer can be detected in the lymph nodes and when survival rates are markedly higher. 

The American Lung Association’s recently published “State of Lung Cancer” report is its fifth annual snapshot of lung cancer trends across the United States. The report focused on incidence, survival, early diagnosis, treatment, screening, and other outcomes nationwide and by race.

State by state, the findings varied widely. Massachusetts saw the highest 5-year survival at 37.9%, and Oklahoma the lowest, at 22.2%. Louisiana, Arkansas, Mississippi, Alabama, and Kentucky all saw survival rates lower than 24.6%, as did New Mexico and West Virginia. 

Incidence of lung cancer was lowest in Utah and highest in Kentucky.

Whereas in Massachusetts, over one third of cases are caught early, the report found, early diagnoses comprised fewer than 23.5% of cases in Oklahoma. Hawaii did worst of all, with 21.1% of cases caught early. 

Massachusetts outperformed the rest of the country in terms of surgical treatment rates, with 31.8% of lung cancer patients undergoing surgery compared with 13% in New Mexico. Nationally, more than one fifth of patients received no treatment at all for their cancers.

Preventive screening was also all over the map, with 28.6% of eligible people screened in Rhode Island vs just 8.6% in Wyoming. 

Nationwide, Black Americans saw rates of surgical treatment, early diagnosis, lack of treatment, and 5-year survival that were 12%-19% less favorable compared with those of White Americans. Among Latino patients, rates of surgical treatment were equal to those of White patients, at 21%, Latinos nonetheless experienced a 30% lower likelihood of being diagnosed early. Indigenous patients were 24% less likely to receive early diagnoses. 

The report cited smoking, exposure to radon gas, air pollution, and secondhand smoke as key factors underlying lung cancer risk in the United States. Radon testing and mitigation, healthy air protections, higher tobacco taxes, antismoking laws, and help quitting smoking were seen as factors that can reduce risk of getting the disease.

The American Lung Association encouraged states to look closely at racial disparities and to promote broader insurance coverage of comprehensive biomarker testing for lung cancer. Currently, only 15 states require insurers to cover this testing, the report found.

“Every state can do more to defeat lung cancer,” the association said. 

Jennie Smith is a freelance science writer.