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Low lung cancer screening rates show an opportunity to save lives

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American Lung Association’s report examines toll of lung cancer state-by-state, underscores urgent need for more people to be screened

The 2022 “State of Lung Cancer” report shows that only 5.8% of eligible Americans have been screened for lung cancer, and some states have screening rates as low as 1%. The American Lung Association’s 5th annual report, released recently, 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.

Lung cancer screening is key to early diagnosis, and early diagnosis saves lives. According to the new report, in 2021, only 5.8% of those eligible were screened. Some states, such as California and Nevada, had screening rates as low as 1.0% and 1.3%, respectively. The best state in the country for lung cancer screening was Massachusetts at 16.3%.

“While lung cancer screening remains underutilized, our new report revealed continued progress for lung cancer survival. The lung cancer five-year survival rate is now 25% and increased 21% from 2014 to 2018,” said Harold Wimmer, National President and CEO for the American Lung Association. “Increased lung cancer survival is attributable to advancements in research, better treatments and other factors, however, lung cancer screening is the most immediate opportunity we have to save lives. If you are eligible for lung cancer screening, we encourage you to speak with your doctor about it. If a loved one is eligible, please encourage them to get screened.”

Currently, 14.2 million Americans meet the US Preventive Services Task Force guidelines for screening. Under these guidelines, a person is eligible for lung cancer screening if they are between 50-80 years of age, have a 20 pack-year history (1 pack/day for 20 years, 2 packs/day for 10 years), and are a current smoker, or have quit within the last 15 years. Find out if you are eligible for lung cancer screening at SavedByTheScan.org.

Close to 237,000 people in the U.S. will be diagnosed with lung cancer this year. The 2022 “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 25%. Survival rates were the best in Rhode Island at 30.8%, while Oklahoma ranked worst at 19.7%.

Early Diagnosis: Nationally, only 25.8% of cases are diagnosed at an early stage when the five-year survival rate is much higher (61%). Unfortunately, 44% of cases are not caught until a late stage when the survival rate is only 7%. Early diagnosis rates were best in Massachusetts (31.9%), and worst in Hawaii (19.5%).

Lung Cancer Screening: 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%. Nationally, only 5.8% of those at high risk were screened. Massachusetts has the highest screening rate at 16.3%, while California has the lowest at 1.0%.

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.

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.

Health Disparities: The report also highlights that people of color who are diagnosed with lung cancer face worse outcomes compared to white Americans, including lower survival rate, 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 46 states’ Medicaid fee-for-service programs cover lung cancer screening, three programs do not provide coverage, and one state did not have information available on their coverage policy.

“State of Lung Cancer” highlights that states must do more to reduce the burden of lung cancer and encourages everyone to join the effort to end lung cancer. Learn more about the report, and take action by emailing President Biden to thank him for his leadership on the Cancer Moonshot Initiative and urge him to work to increase lung cancer screening for individuals at high risk at Lung.org/solc.

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