Lung cancer survival rate in Pa. improves, report says

More Americans die from lung cancer than breast, prostate and colorectal cancer combined.

“Lung cancer is the nation’s leading cause of cancer deaths,” said Deborah Brown, the chief mission officer for the American Lung Association. “It kills 130,000 people annually.”

The ALA’s 2022 “State of Lung Cancer” report, released Tuesday, showed that Pennsylvania was ranked 12th in the nation for lung cancer survival, with a rate of 26.8%, a 22% improvement over the past five years. That is a bit higher than the national rate of people alive five years after a lung cancer diagnosis, which is 25%.

While the state also lowered the rate of new cases and improved treatment opportunities over the past five years, there is still work to be done: Too few residents are getting the life-saving screenings that they need, and minority groups in the state are more likely than white people to die from lung cancer.

A big takeaway from the report is that to improve survival rates, more people must be screened. Dr. Timothy Burns, an associate professor of medicine at the University of Pittsburgh and UPMC Hillman Center and volunteer medical spokesperson for the ALA, said that screenings are the key to early detection.

“It’s been shown again and again that the early stage is the most curable stage of lung cancer,” he said.

One of the problems might be that screenings are not a regular part of routine care. Primary care physicians don’t always recommend them, and patients don’t realize they could be screened.

According to the Allegheny County Health Department’s website, 16.3% of adults in Pennsylvania smoke, putting them at risk for lung cancer. But that’s not the only cause: The state has high levels of radon, a major risk factor and cause of lung cancer.

“Anyone with lungs can get cancer,” Ms. Brown said. Lung cancer screenings should be a routine part of health care for eligible individuals, according to the ALA.

Screenings aren’t just for people who feel symptoms of lung cancer — a cough or shortness of breath, for example. “Screening is actually for asymptomatic people,” Dr. Burns said. “People who don’t have the disease or even feel symptoms of it, that’s who we should be screening.”

He compared it to annual mammograms, saying that many doctors catch breast cancer early thanks to routine screenings, even before patients feel a lump or exhibit any symptoms.

Much like mammograms, low-dose CT scans can find cancer early enough to be treated with surgery — the most effective way to fully eradicate lung cancer. “An annual scan for anyone at high-risk can reduce the death rate by 20 percent,” said Ms. Brown. “When we call this life-saving, it truly is life-saving.”

The net has been cast wider for people who should get screened. The ALA says that 14.2 million Americans meet the eligibility guidelines for a low-dose CT scan that could detect early signs of lung cancer. People between 50 and 80 years old, who have smoked a pack a day for 20 years (or an equivalent rate, such as two packs a day for 10 years) and are current smokers or have quit in the past 15 years are eligible for a screening.

But according to Dr. Burns, being eligible has not translated into actual screenings. “Over 90 percent of Pennsylvania residents who are eligible are not getting screened,” he said.

Both Ms. Brown and Dr. Burns said that Medicaid and Medicare cover screenings for most qualified individuals. However, the way patients can access screenings remains a barrier to care.

Primary care physicians often need to recommend that a patient get a screening and get prior authorization before health care will kick in to pay for it. If a patient doesn’t have a primary care physician, it can be difficult to get a screening scheduled and paid for. According to the ALA report, Pennsylvania has a Medicaid-for-fee service that covers lung cancer screenings. Dr. Burns thinks that might not be enough and encourages broader thinking.

“Think out of the box,” he said. “Get community advocates involved, go to churches and community centers.” He noted that minorities — who have lower rates of treatment and survival in Pennsylvania — may have a historic mistrust of the health care system, which the system must work to overcome. The report said that Asian Americans and Pacific Islanders in Pennsylvania were least likely to be diagnosed early.

Pennsylvanians should also be aware that radon levels are a major risk factor for lung cancer. While smoking causes the vast majority of cases, “Radon is the secondleading cause of lung cancer,” Ms. Brown said. “It is a colorless, odorless radioactive gas that is naturally found in the soil and enters buildings through small gaps and cracks.” Pennsylvania has one of the highest levels of naturally occurring radon in the country.

Home radon tests are a great way for residents to protect themselves by finding out if they have high radon levels in their homes. And according to Ms. Brown, many residents will discover that they, indeed, have elevated levels. “There are high levels of radon in two out of every five Pennsylvania homes,” she said.

By getting screened, checking for radon, and pushing for affordable health care, the ALA believes Pennsylvania can better treat lung cancer patients and improve survival rates statewide.

“It’s an underappreciated cancer in terms of the impact it has on our society,” Dr. Burns said.

The good news is that there have been improvements in treating and preventing lung cancer. “This report has shown year after year that there is progress for lung cancer survival,” Ms. Brown said. “That’s really promising and hopeful. But we know there is still a lot of work to be done.”

Pennsylvania was ranked 12th in the nation for lung cancer survival, with a rate of 26.8%, a 22% improvement over the past five years.