‘State of Lung Cancer’ Report Reveals Worse Outcomes in Patients of Color

Patients of color who were diagnosed with lung cancer were associated with worse outcomes compared with Caucasian patients, according to findings from the 3rd Annual “State of Lung Cancer” Report by the American Lung Association.

This observation may be due to the facts that people of color with lung cancer are less likely to be diagnosed early, less likely to undergo surgery, and more likely to receive no therapy. This report annually tracks the toll of lung cancer, known as the leading cause of cancer death in the country, by state, but for the first time, the burden of lung cancer among different racial and ethnic groups at the national and state levels was explored as well.

“Lung cancer is often referred to as the silent killer, as it has few symptoms and is typically found in later stages when it’s less curable,” said Harold Wimmer, president and chief executive officer, American Lung Association, in a statement. “The American Lung Association has long worked to bring lung cancer out of the shadows, and to fully uncover the toll of lung cancer and save more lives. To accomplish this, we must also address the disproportionate burden faced by people of color.”

According to the report, more than 228,000 individuals in the United States will be diagnosed with lung cancer in 2020, and while this remains the leading cause of cancer deaths, the 5-year survival rate has increased from 13% to 33.6% over the last 5 years. The reported notes that the survival rates were best in Connecticut (27.1%), Minnesota (26.9%), and New Jersey and Rhode Island (25.9%, each), while the worst 5-year survival rates were observed in Alabama (17.1%), Mississippi (17.6%), and Louisiana (18.1%).

Early diagnosis was also explored in this report considering the diagnosis of disease prior to its spread is key to survival. Over the last 5 years, early diagnosis rates have increased 33% to 22.9% nationally, and these rates were best in Massachusetts (28.8%), Wyoming (28.6%), and Connecticut (27.2%), while the worst were in Hawaii (18.0%), Alaska (18.6%), and New Mexico (19.0%).

Screening plays an important role in improving early diagnosis. While it is estimated that 8 million people are considered high risk for lung cancer, who are recommended for screening, only 5.7% were screened in 2019. The screening rates were best in Massachusetts (18.5%), Vermont (13.8%), and New Hampshire (12.1%), and the worst were in New Mexico (1.6%), California (1.2%), and Nevada (1.0%).

The report also evaluated treatments in patients diagnosed with lung cancer, and these findings demonstrated that nearly 1 in 6 patients (15.2%) do not receive any therapy after receiving their diagnosis. Lack of treatment rates were best in North Dakota (7.5%), Massachusetts (9.4%), and Missouri (9.5%), while these were worst in Arizona (29.5%), New Mexico (23.8%), and California (22.9%).

According to findings regarding racial disparities in the report, African Americans with lung cancer were 16% less likely to have an early diagnosis, as well as 19% less likely to undergo surgery and 7% more likely to not receive any treatment for the disease compared with Caucasian counterparts. In an analysis of the Latino population, these patients were 13% less likely to be diagnosed early, 2% less likely to receive surgery, and 39% more likely to receive no therapy compared with Caucasians.

Asian Americans/Pacific Islanders were 15% less likely to be diagnosed early. These patients with lung cancer were 10% more likely to receive no treatment, but they were also 11% more likely to receive surgery as treatment compared with Caucasians. The Indigenous group, including American Indians and Alaska Natives, with lung cancer was 14% less likely to be diagnosed early, 19% less likely to receive surgery, and 15% more likely to go without treatment.

About half of the 30 million uninsured people in the United States are of color, and research has demonstrated that whether or not a person has health coverage impacts their medical care and health outcomes. It is critical to address these racial disparities in lung cancer in order to improve patient outcomes.

_Reference

_{‘State of lung cancer’ report finds people of color face greater burden, worse lung cancer outcomes. News Release. American Lung Association. November 17, 2020. Accessed November 18, 2020. https://bit.ly/36Lij4y}