Lung cancer survival rates improve, more to do

Last week, the American Lung Association’s released its seventh annual “State of Lung Cancer.” Overall, the Association happily reported that the lung cancer survival rate has risen 26% in the past five years. Lung cancer has one of the lowest five-year survival rates among leading cancers because it is often not detected until a late stage when it is less likely to be curable.

While there were several positive data points for California, there were also two important issues whose improvement will benefit State residents.

California ranked low for both availability of treatment and, importantly, for early diagnosis and screening.

Early diagnosis and screening are critical to help those who are in the early stages of lung cancer. Nationally, only 27% of individuals in the early stages of lung cancer are diagnosed with the disease. Nearly 64% of these people have at least a five-year survival rate. For those whose cancer is not identified until late stages, when it has already metastasized, the five-year survival rate declines to 9%.

With a 25.9% rate for early diagnosis, California ranks 36^(th) nationwide, but this is slightly better than the national average of 27.4%. Overall, early diagnosis has improved 11% in the past five years.

The State is also 36^(th) for lung cancer screening. “Screening with annual low-dose CT scans can reduce the lung cancer death rate by up to 20%, by detecting tumors at early stages when the cancer is more likely to be curable,” the Report’s authors wrote.

Screening is strongly recommended for those with a high risk of incurring lung cancer. The United States Preventive Services Task Force has three criteria for high-risk individuals.

Individuals between 55 years and 80 years of age and the equivalent of smoking one pack of cigarettes a day for 20 years. One who smokes two packs per day for ten years meets this criterion. The third criterion is still smoking or having quit less than 15 years ago.

Nationally only 16% of high-risk individuals receive a low-dose CT scan. In California, only 13.9% of the high-risk population has a screening done. For those who do have screenings, the death rate can fall by 20%.

With a rate of 25.8%, California is near the bottom for individuals who do not seek treatment. Nationwide about one-fifth of lung cancer cases do not have a treatment plan.

However, California is much closer to the top of the rankings for both overall survival at 28.4% and for those with lung cancer who seek surgery. The best survival percentage was 37.9% in Massachusetts, California’s was 14^(th), and the worst was 22.2% in Oklahoma.

In the State, 22.1% of patients undergo surgery, compared to 20.7% nationally. Surgery is a very successful treatment for those who are diagnosed early.

“Lung cancer is a devastating disease and impacts far too many families in California. To address the burden of lung cancer and to help improve the lives of people it impacts, we must continue to evaluate the greatest needs,” said Kesa Bruce, Director of Advocacy for the American Lung Association. “This year’s ‘State of Lung Cancer’ report shows that California must focus on improving treatment rates. Together, we can make a difference.” 

The major causes or contributors to lung cancer have been found to be tobacco use and exposures to radon, air pollution and secondhand smoke,

“Tobacco use is the leading risk factor for lung cancer, accounting for 80 to 90% of cases. . . Secondhand smoke has also been shown to cause lung cancer. . . [and] Radon, a naturally occurring radioactive gas, is the second leading cause of lung cancer and the leading cause among nonsmokers,” according to the Report.

Exposure to year-round particle pollution in the air has been shown to cause lung cancer. In April, the American Lung Association released its “State of the Air” report.

While California’s air quality is improving, it is generally not considered good. Of 50 counties, for which there were data, 11 received an “A” grade for ozone pollution. Most of these were small and in Northern California.

However, 29 counties, half of the state, were graded “F.” This included Los Angeles, Orange, San Bernardino, San Diego and Riverside counties.