US Lung Cancer Survival Rate Increases 21%, Report Says, But Still Needs to Be Done



CNN

The five-year survival rate for lung cancer has rose 21%, from 21% in 2014 to 25% in 2018, making what experts call “remarkable progress” – but it remains the leading cause of cancer death in the United States.

However, in communities of color, a person’s chance of surviving five years after diagnosis is much lower, at just 20%, according to the 2022 State of Lung Cancer Report, released Tuesday by the American Lung Association.

The survival rate varies from state to state. Oklahoma has the lowest rate, at 19.7%, and Rhode Island has the highest rate, at 30.8%.

“A 21% increase in five-year survival is good. I don’t think there are too many other groups that have seen this level of improvement,” said Dr. Jeffrey Crawford, a medical oncologist at Duke Health who was not involved in the new report.

The generally low survival rate is largely due to the fact that people often only find out they have cancer at advanced stages of the disease.

The chances of surviving cancer increase dramatically when diagnosed early. About 44% of lung cancer cases are only detected at an advanced stage, when the survival rate is only 7%, the report said.

In 2021, the US Task Force on Preventive Services expanded its lung cancer screening recommendations. It now urges testing of anyone aged 50 to 80 who has a ’20-pack-year smoking history’, meaning they have smoked one pack a day for 20 years or two packs a day for 10 years old, whether she currently smokes or has quit within the past 15 years.

In 2021, only about 5.8% of the recommended population have been screened, the new report says.

“When lung cancer screening is implemented, cancers are detected earlier, when they are more curable. There’s a tremendous amount of progress to be made there,” said Dr. John Heymach, director of thoracic/head and neck medical oncology at MD Anderson Cancer Center, who was not involved in the new research. “And 5.8% is actually an improvement from before, but those numbers are still miserably low.”

Some research suggests that up to 60,000 lives could be saved each year if the 14.5 million Americans recommended to be screened for lung cancer.

Almost all private insurance companies reimburse screening costs. Most are required to do so under Obamacare. The only plans that aren’t required to cover these tests are state Medicaid programs, but most states do.

“It is disappointing that the advances we are seeing are not due to massive success in lung cancer screening, which is what we should be doing. We are still only screening a minority of patients,” Crawford said.

He said part of the problem may lie at the primary care level.

“We haven’t been able to get primary care doctors to change their attitude towards lung cancer because for decades I think there’s been a kind of pessimism about lung cancer. . They say it’s a smoker’s disease and the results are poor, or they think the patients won’t be healthy enough to have surgery, so there’s no need to screen,” Crawford said. “There are all kinds of misconceptions that just aren’t true anymore, but I don’t think we’ve really gotten that message across unlike mammography for breast cancer. No one is going to argue about this.

People of color are much less likely to be diagnosed with early-stage lung cancer, the report says.

Members of black and Latino communities were 15% less likely to be diagnosed with lung cancer early than white people. Asian Americans were 16% less likely to be diagnosed early.

Latinos with lung cancer were 28% more likely than whites to receive no treatment. For blacks, it was 10%.

American Indians with lung cancer were 13% less likely to be diagnosed early, 21% less likely to undergo surgical treatment, and 23% less likely to survive five years than white people.

Nationally, the number of cases fell by 11% from 2014 to 2018. Nearly 237,000 people will be diagnosed with lung cancer this year, according to the report.

Cancer rates vary by state. Kentucky, for example, has the worst lung cancer rate. That’s almost 2.3 times the incidence rate in Utah, which has the best rate. This is due to differences in things like available treatments, insurance coverage, and risk factors.

It’s not just smokers who get lung cancer. Other risk factors include exposure to second-hand smoke, radon gas, and air pollution.

About 137 million people live in areas of the United States that have failing grades for unhealthy levels of air pollution, according to the American Lung Association’s 2022 State of the Air Report.

The new report does not explain why the number of lung cancers has declined over the years. One reason may be that fewer people are smoking in the United States than 15 years ago, as noted by the US Centers for Disease Control and Prevention.

“Smoking cessation efforts over the years and the reduction in second-hand smoke due to policies in restaurants and other public places that restrict smoking have truly been fantastic successes from a public health perspective and saved lives. thousands of lives a year,” Heymach said.

Treatments have also “significantly improved”, he said, with “dramatic progress” in survival.

Just ten years ago, for someone with cancer that has spread to other organs, the chance of surviving five years was less than 5%. The expected survival rate was approximately one year.

But with the discovery of targeted therapies known as EGFR inhibitors, pills that target specific mutations in lung cancer, expected survival is now over four years, Heymach said.

These therapies only apply to the 40-50% of patients who have a mutation that can be targeted with a pill.

For others, immunotherapies like PD-1 inhibitors are used to stimulate the immune system to attack the cancer and improve the chances of five-year survival by more than 10%.

“It’s not as high as we would like, but it’s still remarkable progress,” Heymach said. “All of these therapies have really made dramatic differences.”

He says there’s still a lot to be done to help people with lung cancer, but things are looking up.

“Of all the advances in cancer survival over the past few years, a large percentage of those have been specifically linked to lung cancer. Lung cancer is therefore the type of cancer with the most spectacular advances in cancer therapies, and this is certainly a welcome change, because for a long time there has been no progress.

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