Lung cancer remains the leading cause of cancer death in the US among both women and men. In fact, lung cancer accounts for about one-quarter of all US cancer deaths, more than breast, prostate and colorectal cancers combined.
While the number of newly diagnosed cases of lung cancer continue to decline – driven largely by reductions in smoking, there remains much work to be done. Barriers, delays and disparities continue to impact patients’ access to important tools such as screening, diagnostic tests and treatments. Adding fuel to the fire is the persistence of stigma and the misconception of lung cancer as a death sentence, which can impact everything from how patients seek care to research funding.
It’s time to talk about lung cancer. Continue reading below to help inform your conversation.
The Impact of Stigma
While decades of anti-smoking campaigns have led to a huge decline in smoking prevalence, they have also resulted in a pervasive stigma around lung cancer with its own serious consequences.
Unlike many other cancers, lung cancer is considered by many to be a matter of personal responsibility because of its strong association with smoking. Because of this, people are often perceived as being to blame for their cancer — a perception that often exists regardless of a person’s actual smoking status.
People with lung cancer report the highest levels of stigma and psychological distress compared to people with any type of cancer. This stigma can have significant and far-reaching effects.
· For patients: Stigma has been cited by some individuals as a reason to delay visiting a doctor and seeking care. For those who do visit their doctor, stigma can act as a barrier to having a frank discussion about smoking status and important considerations like lung cancer screening.
· For healthcare providers: Negative perceptions of lung cancer can impact treatment decisions and may result in the underuse of potentially beneficial therapies and a decrease in the low-dose CT (LDCT) screening referrals for eligible patients.
· For the cancer community: Stigma has resulted in significant disparities in research funding and limited support for broad public screening initiatives.
Anyone with lungs can get lung cancer. While smoking may be the leading cause of lung cancer, nearly 15% of lung cancer cases occur in never smokers— making lung cancer in non-smokers one of the top ten causes of cancer-related deaths. Everyone, regardless of whether or not they’ve smoked, deserves compassion and access to quality care.
The Importance of Screening
Because recognizable symptoms of lung cancer often do not occur until the disease has advanced, LDCT screening is an important tool in addressing the impact of lung cancer in high-risk populations. The United States Preventive Services Task Force recommends yearly lung cancer screening with a LDCT scan for people between 50 and 80 years old who:
• Have a history of heavy smoking (at least a pack a day for 20 years) and
• Smoke now or have quit within the past 15 years
Increasing lung cancer screening and earlier detection of the disease have the potential to significantly reduce lung cancer mortality rates for those most at risk.
Despite this, national lung cancer screening rates remain extremely low, with a recent analysis finding only 5% of eligible adults were screened in 2018, compared to 72.8% for breast cancer and 66.8% for colon cancer.
It’s important for those who may be eligible to talk to their doctor about whether lung cancer screening may be right for them.
Ensuring Access to Care
Disparities in lung cancer incidence, diagnosis, treatment, and mortality are well-documented and particularly prevalent among minority communities, individuals of low socioeconomic status, and uninsured or underinsured populations. These disparities can compound the challenges of an already difficult disease.
The difficulties in detecting lung cancer early means that nearly half of lung cancer cases in the US are not detected until a late stage. Specifically in non-small cell lung cancer, the survival rate is only 7% when the cancer has spread to distant parts of the body. People of color are even less likely to be diagnosed early when there is opportunity to treat with the intent to cure.
Ensuring that everyone, regardless of their race/ethnicity, gender, socioeconomic status or geographic location, has access to quality care is key to moving the needle against lung cancer. In fact, strategies to eliminate care gaps for at-risk groups have been shown to improve outcomes for all patients.
Addressing disparities in lung cancer will require coordination and commitment from stakeholders across the lung cancer community and a multi-pronged approach (awareness, education, patient support, etc.) to target barriers at the patient, provider, healthcare-system and community level.
Fighting Fear and Finding Hope
Despite the common misconception of lung cancer as a death sentence, recent advances are actually redefining the way many in the lung cancer community think about living with and treating the disease. For example, early-stage non-small cell lung cancer has the potential to be treated with curative intent.
But the continued misconception of lung cancer as a death sentence can have serious impacts on this progress. Fear and nihilism can impact treatment decisions that could potentially result in delays in care, the underuse of newer therapies, or adherence to treatment, ultimately leading to poorer patient outcomes.
While challenges remain, it’s important for those impacted by lung cancer to have hope.
Changing the Conversation
The US is expected to see an estimated 235,760 new cases of lung cancer and 131,880 lung cancer deaths in 2021. While challenges remain, there is hope on the horizon and meaningful change is possible – but only through conversation and action.
Talk to your doctor, your local politicians, your friends, your grandparents, your parents, your partner. Together we can make a difference, starting with the goal of doubling five-year survival by 2025 and aiming to one day eliminate lung cancer as a cause of death.