By Pat Basu, M.D.
President & CEO, Cancer Treatment Centers of America and
Albert Rizzo, M.D.
Chief Medical Officer, American Lung Association
As we enter the eighth month of the COVID-19 pandemic, we must not forget about other diseases, especially those that may make someone more susceptible to the most serious complications of COVID-19. Lung cancer is the #1 cancer killer in the U.S., but according to new research, only a small fraction of the public is aware of this fact.
In 2020 alone, it is estimated that more than 225,000 Americans will be diagnosed with lung cancer and 135,000 will lose their life to this deadly disease. In addition, lung cancer death rates are 23% greater among black men compared to white men, and survival rates are 12% lower among black people.
In Oklahoma, the trends are even more concerning. The rate of new lung cancer rates is the 10th worst in the country and the five-year survival rates is also one of the worst in the nation. Even more concerning is that only 1.4% of people at high risk are screened in Oklahoma. That number needs to change immediately.
If you’re not aware of those statistics, you’re not alone. According to the 2020 National Lung Health Barometer just released by the American Lung Association and Cancer Treatment Centers of America, only 8% of adults know lung cancer is the number one cancer killer of women in the U.S. and just 21% of adults know the disease is the leading cancer killer of men.
The number of people in the group at high risk for lung cancer is substantial. Approximately eight million Americans meet the screening criteria and are at high-risk for lung cancer due to smoking history. Screening of these individuals could result in 48,000 lives saved. Unfortunately, only about 5% of people in the high-risk group have been screened.
Like other cancers, early detection and treatment lead to higher survival rates. While everyone should be taking precautions against COVID-19, given the critical importance of screening for lung cancer, those at high risk should not delay this conversation with their doctor. A low-dose CT screening can decrease lung cancer mortality by up to 20% among high-risk adults, but since people at high risk don’t get screened for lung cancer as frequently as other cancers, only 17% of cases are diagnosed early, when the disease is most treatable. When detected and treated at stage I, lung cancer has a nearly 63% five-year survival rate. That rate drops to 41% at stage II; 18% at stage III; and 4% at stage IV.
Which begs the question, why aren’t more people getting screened for lung cancer?
First, even though COVID-19 has impacted the normal workflow of many screening centers, adults at high risk must be diligent in working with their healthcare provider to get screened as soon as possible.
Second, awareness is low. Too few adults understand that lung cancer is among the cancers most likely to affect women (20%) and men (34%).
The third and perhaps most important barrier is a lack of support for lung cancer screening within our healthcare system. More than one quarter of people within the Medicaid system (26.3%) are current smokers and thus at higher risk for a diagnosis of lung cancer, yet ten state Medicaid programs do not cover lung cancer screenings. That must change.
What can be done to help reverse this trend?
Know your risk. If you don’t know your lung cancer risk, visit SavedByTheScan.org to take a simple eligibility quiz. If you are at risk, make sure you speak with your doctor about getting screened.
Get your routine screening: For those at high risk, screening is recommended annually. Hospitals and other screening facilities now understand COVID-19 precautions and you should ask them for information about how you will be protected during your visit.
Talk to your family: If a loved one might be at high risk for lung cancer, tell them about the importance of talking to their doctor about screening. Your advice might save their life.
One day, COVID-19 will be a distant memory. Our aim should be the same for lung cancer.
By Pat Basu, M.D.