The lung cancer survival rate has improved 26% in the last five years, according to the American Lung Association’s annual State of Lung Cancer report, published Tuesday.
But much work remains to get eligible people screened for lung cancer and expand affordable access to targeted treatments made possible by biomarker testing.
Close to 235,000 people in the U.S. will be diagnosed with lung cancer this year, a cancer type with only a 28% five-year survival rate.
“The most common cause of death from cancer is from lung cancer,” said Dr. Jamie Garfield, a national spokesperson for the American Lung Association. “Far more than breast, prostate, colorectal, all of those combined.”
Yet just 16% of eligible people get screened for lung cancer, far lower than screening rates for colorectal or breast cancer.
“So, if you smoked a pack a day for 20 years, you qualify for screening for lung cancer,” Garfield said. “If you smoked half a pack a day for 40 years, that also qualifies.”
Many insurance companies didn’t routinely pay for lung cancer screenings, but that has changed, Garfield said. Now, a lack of awareness is the primary hurdle to getting more people screened.
That’s part of the mission of the American Lung Association’s annual report. The screenings consist of annual low-dose CT scans. Only about 27% of cases are diagnosed at an early stage, when the five-year survival rate is much higher at 64%.
There are genetic causes for lung cancer, but Garfield said tobacco and tobacco-related products account for the vast majority of cases. She said more people who are still struggling with tobacco use disorder are now willing to come in for screening.
“We had to divorce the shame of tobacco product use from the diagnosis of lung cancer, and I think that’s work that still needs to be done,” Garfield said.
Another focus of this year’s report was on biomarker testing. Surgery is an option when the cancer is isolated to one part of the lung.
Chemotherapy is usually offered when the cancer spreads, but Garfield said the harshness of chemotherapy can dissuade people from receiving treatment.
Chemotherapy kills tumor cells, which are rapidly growing, but it also kills healthy cells in the body. Patients can suffer powerful side effects, such as hair loss and stomach issues.
Biomarker testing reveals information about the tumor biology that couldn’t have been discovered five or 10 years ago, Garfield said. And drugs exist that target a very specific genetic mutation in some tumors. The medication would only kill those tumor cells, not the healthy cells in the body.
But biomarker testing is cost-prohibitive for many patients. Only 15 states require insurance coverage of comprehensive biomarker testing. Five states require some plans to cover testing, and 30 states and Washington, D.C., have yet to require any coverage of biomarker testing, according to the American Lung Association.
Garfield said state leaders have the power to improve coverage of biomarker testing for their residents.
“Biomarker testing has absolutely revolutionized the way we treat lung cancer,” she said.
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