Lung Cancer Overall Survival Remains Low Among People of Color Despite Rates Increasing Nationally

Despite 5-year survival increasing nationally for patients with lung cancer, patients of color continue to experience poor survival.

Although national lung cancer 5-year survival rates have increased from 14.5% to 23.7%, research indicates that survival continues to be low among people of color, according to the American Lung Association's State of Lung Cancer report.1

The report indicated that communities of color had a 5-year survival of rate of 20%, with Black patients specifically having a survival rate of 18%. Additionally, Black patients were 18% less likely to receive an early diagnosis and 23% less likely to receive surgical treatment vs White patients. Moreover, Black patients were 9% more likely to not undergo any type of treatment and 21% less likely to survive for 5-years compared with their White counterparts.

“The report highlights important news–more people are surviving lung cancer; however, it also underscores the fact that, sadly, health disparities persist for communities of color. …Everyone deserves the opportunity to lead a full and healthy life, so more must be done to address these health disparities,” Harold Wimmer, national president and chief executive officer for the Lung Association, said in a press release.2

The State of Lung Cancer report assesses the burden of lung cancer among different racial and ethnic groups at both a national and state level. The 2021 report also explored the potential of lung cancer screenings, as well as other important advancements in the space that could help to improve treatment options.

The report does not consider the impact of the COVID-19 pandemic on diagnosis, treatment, or survival since the included data preceded the virus.

The United States Preventive Service Task Force expanded its lung cancer screening recommendations in March 2021 based on new findings to include a wider age range, as well as additional current and former smokers. The changes significantly increased screenings for Black and female patients who were at high risk for lung cancer.

Although screening rates have increased nationally following the recommendations, the rate did not change from 2019 to 2020. However, this was likely because of lockdowns set in place during the COVID-19 pandemic.

At a state level, survival was best in Connecticut (28.8%) and worse in Alabama (18.4%). Early diagnosis rates (30%) and lung cancer screenings (17.8%) were highest in Massachusetts. Additionally, Hawaii had the worst rates of early diagnosis (19%) and both California and Wyoming had the lowest screening rates (1.0%).

Other findings from the report indicated that Latino patients were 16% less likely to receive an early diagnosis and were as likely to undergo surgery as their White counterparts. Additionally, Latino patients were 26% more likely to not undergo treatment, as well as 16% less likely to survive past 5 years vs White patients.

In the Asian American/Pacific Islander population, patients were 18% less likely to receive an early diagnosis and were 5% more likely to not undergo any type of treatment vs White patients. Notably, the population was 17% more likely to undergo surgery and 9% more likely to survive up to 5 years compared with White patients, setting them apart from other racial groups.

Indigenous individuals were 17% less likely to receive an early lung cancer diagnosis, as well as 25% less likely to undergo surgery vs their White counter parts. They were also 11% less likely and 13% less likely to not undergo any type of treatment or survive for 5 years, respectively.

On a national level, the report indicated that 24% of lung cancer cases are diagnosed at an early stage with a high 5-year overall survival rate of 60%. However, lung cancer was more likely to be diagnosed at a later stage (46%) with a notably lower survival rate (6%). The use of yearly low-dose CT scans for patients who are at high risk for lung cancer was found to reduce the death rate by up to 20%. However, only 5.7% of high-risk patients have been screened.

Although early-stage lung cancer that has not spread can be treated with surgery, only 20.7% of patients received a surgical intervention. Investigators believe that there are several reasons why patients may not undergo treatment, including a lack of provider/patient knowledge, the stigma related to a lung cancer diagnosis, fatalism following diagnosis, and costs. Potentially due to this, 21.1% of patients did not receive treatment.

References

  1. Lung cancer key findings. American Lung Association State of Lung Cancer.Updated November 12, 2021. Accessed November 17, 2021. https://bit.ly/3nnUZDi
  2. New report: lung cancer survival has increased, but remains significantly lower for people of color. News release. American Lung Association. November 16, 2021. Accessed November 17, 2021. https://bit.ly/3kKPyg8