More people with lung cancer are living longer, but it remains America's deadliest cancer, a new state-by-state report shows.
"There is more work to do, but I am incredibly optimistic about the future of lung cancer care," said Harold Wimmer, president and CEO of the American Lung Association (ALA), which documents improved survival rates and opportunities to do more in its 2024 "State of Lung Cancer" report.
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In the past five years, the lung cancer survival rate has improved 26%, according to the report. It credits deployment of biomarker testing — which looks for changes in a tumor's DNA — as a key factor. Biomarker testing can help tailor treatments to individual patients, it points out.
But, the report notes, access to the testing, which is also called molecular, genomic or genetic testing, is uneven. Only 15 states require comprehensive insurance coverage for it, while five more require some insurance plans to include it.
"This year's 'State of Lung Cancer' report provides a path for states and the federal government to take to improve the lives of people living with this devastating disease," Wimmer said in an ALA news release. "Increasing lung cancer screening rates and expanding biomarker testing are enormous opportunities to catch cancer earlier and provide the best treatments for people diagnosed with the disease."
The new report tracks both nationwide and state-by-state screening rates. Last year, 16% of those eligible nationwide were screened for lung cancer, according to the report.
Rhode Island had the nation's best screening rate (28.6%), while Wyoming had the worst (8.6%). The report projects that nearly 235,000 people nationwide will receive a lung cancer diagnosis this year.
Because many patients aren't diagnosed until their lung cancer is in a late stage, when it is less likely to be curable, the five-year survival rate is 28.4%. That's the percentage of patients who were alive five years after their diagnosis.
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Massachusetts had the top survival rate, 37.9%. Oklahoma's 22.2% survival rate was the worst.
Nationwide, 27.4% of lung cancers are diagnosed at an early stage, and those have a higher survival rate, at 64%, according to the report. But 43% of cases aren't caught until a late stage. At that point, the survival rate plummets to 9%.
Massachusetts had the best rate of early diagnosis, 34.7%, and Hawaii the worst, 21.1%.
When diagnosed early, before it has spread, lung cancer is often treated with surgery. Nationwide, 20.7% of cases were treated surgically.
Roughly the same percentage of cases -- 20.9% -- were not treated at all. The report said there are many reasons why, but lack of provider or patient knowledge, cancer-related stigma, fatalism after diagnosis or cost should never be a factor.
Nevada had the highest lack-of-treatment rate — 36.7% — and Massachusetts, the lowest, 13.2%.
As is the case across health care, the report noted that minorities have worse outcomes than white patients. They are less likely to be diagnosed early or undergo surgery and are more likely to go untreated.
"More must be done to eliminate lung cancer health disparities," the ALA said.
It called on all states to require insurance coverage of biomarker testing.