Medical Technology

One quarter of lung cancer patients still live after five years.

Patients suffering from lung cancer have seen their survival rates increase in recent years. Now, nearly one quarter of patients with lung cancer are still alive five years after diagnosis.

This new data is highlighted in the State of Lung Cancer report from the American Lung Association (ALA), published online on November 16.

“If you take a look back, the 5-year survival rate has been very slowly eeking up at about 1% over the years,” commented Andrea McKee, MD, volunteer spokesperson at the ALA she told Medscape Medical News. The report shows that the 5-year survival rate grew by 14.5 percent over the past five years. She said that “To see this huge jump is truly impressive and something we all celebrate.”

“But we have to change the fatalistic beliefs that patients and primary care doctors still hold regarding lung cancer. She stated that the majority of people believe that anyone who has been diagnosed with lung cancer has passed away. However, that is no longer true. Lung cancer is treatable in its early stages. There are other treatments that are available, even if they are not yet advanced.

McKee said that “So we have to change the perception of primary care,” even though it is already prevalent on part primary care providers.

Lung Cancer is declining but it is being detected late

The report states that the risk of being diagnosed with lung cancer differs considerably across the United States. For example, lung cancer rates in Kentucky are nearly 2.5 times higher than in Utah.

Overall, the incidence is decreasing. “Over the last five years, the incidence of new cases has decreased by 10% across the country,” the authors point out.

However, in almost half of the cases the disease is detected in the latter stages.

When diagnosed at a late stage, the 5-year survival rate for lung cancer decreases to only 6%, however, if the cancer is detected early the 5-year survival rate is 60 percent.

At present, around 24% of cases of lung cancer are detected at early stages according to the report however it varies across the United States. The highest percentage (30%) is found in Massachusetts and the lowest rate (19 percent) is in Hawaii.

The percentage of lung cancer cases that are diagnosed early has been steadily increasing, presumably in part due to the introduction of low-dose CT screening for those at risk (such as smokers).

The report shows that only 5.7 percent of those at risk for lung cancer were annually screened with low-dose CT.

McKee stated, “CT screening is so effective at saving lives that even with just five percent of the people who have been able to test it I believe it makes a difference.” That small national percentage still is a significant portion of patients, she added, “so even with what we’ve accomplished so far, I believe that screening is making a difference, at least within my own practice, where I’m definitely seeing it,” McKee emphasized.

McKee said that recent changes to recommendations regarding who should be being screened for lung cancer “have almost doubled” the US screening population. McKee stated that there are about 15 million people who must be screened. It is also helpful that primary care physicians know that screening is extremely effective in detecting early-stage lung cancer.

She also noted that the majority of lung cancer cases detected in her hospital’s screening program (88 percent) are in stage I or II. The cure rate for this stage is about 90 percent.

Primary medical doctors also believe that lung cancer screening is costly and has an extremely high false positive rate. The previous research in medical literature suggested that the rate could be up to 96%. “This is completely, positively wrong. McKee said that this isn’t the false negative rate. The false positive rate for lung carcinoma screening is less than 10%.”

She emphasized that primary care providers must also be aware of the changes.

Racial Disparities Featured in Report

The report also highlights the differences in racial makeup that persist in all aspects of lung cancer management — early diagnosis and surgical treatment, ineffectiveness of treatment, and even survival.

Black Americans are 18% more likely to be diagnosed with early-stage cancer than their White counterparts and 23% less likely receive surgical treatment. They are also significantly more likely to receive no treatment at all and mortality from lung cancer among Black patients is 21% higher than for White patients.

This trend is also seen in Latinx patients who are just as likely to undergo surgery as White patients.

McKee stated that , first and foremost, “we must ensure that the Blacks as well as Latinos are screened equally.” She suggested that screening communities of color could be an effective strategy to improve screening rates.

Outreach programs that involve experts in lung cancer working with leaders from these communities can also be used. People are more likely to listen and learn from their leaders about the importance of screening for lung cancer early detection.

Physicians also need to emphasize that even for those who quit smoking decades ago, once they are in their 70s, “there is a spike again in lung cancer diagnoses and this is true for both Black and White patients,” McKee stressed.

“Again this is something that doctors aren’t aware of,” she emphasized.

McKee has not disclosed any relevant financial relationships.

American Lung Association. State of Lung Cancer. Published online on November 16, 2021. Full text

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