Lung cancer survival rates rise, but low screening rates leave many people at risk

Survival rates for lung cancer are improving, especially among historically marginalized communities of color, according to a new survey from the American Lung Association released Tuesday.

The findings are a bright note amid deepening racial disparities in many areas in health care.

The five-year lung cancer survival rate increased by 22% in the five years between 2015 to 2019. It currently stands at 26.6% across all racial and ethnic groups. Among people of color, the survival rate increased by 17% in just two years (2017-2019), and now stands at 23.7%.

The survey results were "unexpected," says Zach Jump, director of epidemiology and statistics for the American Lung Association, adding that the speed with which racial disparities appear to be closing is remarkable.

"We are encouraged by the work being done to eliminate lung cancer stigma, increase lung cancer screening and improve lung cancer treatment," said Harold Wimmer, president and CEO of the American Lung Association in a statement.

Lung cancer is still the cancer that kills the most Americans, with 127,000 deaths last year. People of color tend to be diagnosed at later stages than their white counterparts, and are less likely to get access to treatments like surgery, which historically have reduced their likelihood of survival.

Survival improvements are not equal across all the races and some disparities still exist. The white survival rate is 25%, but the survival rate is 21% for Black Americans, 22% for Indigenous peoples, and 23% for Hispanics. These rates are an improvement over data from two years earlier, when the survival rates were only 18% for Black Americans, and 19% for Indigenous peoples and Hispanics.

Asian Americans survive lung cancer at higher rates than whites, and their survival rate jumped from 23.4% to 29% over two years.

Jump says he hopes these improvements can be continued, and replicated across other racial disparities in health care. "Honestly, that is our next question: Trying to find out what the driving factor is behind it."

The report also notes some stark geographic disparities in lung cancer survival rates. Patients in Rhode Island had a 33% survival rate, while Oklahoma's was 21%.

Overall lung cancer five-year survival rates are markedly lower than many other cancers. Breast cancer, for instance, has a 91% five-year survival rate, and colorectal cancer's rate is around 65%.

Survival rates for lung cancer could be higher, Jump says, if more people at high-risk got annual low-dose CT scans, which are an effective way to catch the disease early. When caught at an early stage, lung cancer's five-year survival rate is much higher at 63%.

But last year only 4.5% of those eligible were screened for lung cancer — a rate far below that for breast or colorectal cancers.

In fact, just over a quarter of lung cancer cases are diagnosed at an early stage, according to the report, and 44% of cases are not caught until a late stage when the survival rate is only 8%.

Jump says lung cancer does not have to be the same dire diagnosis it once was, thanks to recent new treatments that are proving very effective, especially when used at an early stage. "Suddenly you started getting these targeted immunotherapies, and it was a paradigm shift," he says.

Jump says he hopes screening rates will improve, pushing survival rates higher.

It's rare to see such dramatic improvements in cancer care, and survival rates over such a short time, especially in ways that benefit disadvantaged communities.

"So often, cancer care in general and lung cancer especially moves at a pretty slow pace," Jump says. "So being able to see significant progress over a couple of years has been very exciting and definitely a cause for optimism."