The 2022 State of Lung Cancer report by the American Lung Association revealed that only 5.8% of eligible Americans had been screened for lung cancer in 2021, and some states had screening rates as low as 1%. The 5th annual report highlighted how the toll of lung cancer varied by state and examined key indicators throughout the United States—including new cases, survival, early diagnosis, surgical treatment, lack of treatment, and screening rates.

According to the new report, some states—such as California and Nevada—had 2021 screening rates as low as 1.0% and 1.3%, respectively. The state with the highest lung cancer screening rate was Massachusetts, at 16.3%.

“While lung cancer screening remains underutilized, our new report revealed continued progress for lung cancer survival. The lung cancer 5-year survival rate is now 25%, and increased 21% from 2014 to 2018,” said Harold Wimmer, National President and Chief Executive Officer of the American Lung Association. “Increased lung cancer survival is attributable to advancements in research, better treatments, and other factors; however, lung cancer screening is the most immediate opportunity we have to save lives. If you are eligible for lung cancer screening, we encourage you to speak with your doctor about it. If a loved one is eligible, please encourage them to get screened.”

Currently, 14.2 million Americans meet the U.S. Preventive Services Task Force guidelines for screening. Under these guidelines, a person is eligible for lung cancer screening if they are aged 50 to 80 years, have a 20 pack-year smoking history (one pack per day for 20 years or two packs per day for 10 years), and are a current smoker or have quit smoking within the past 15 years. Additionally, close to 237,000 people in the United States will be diagnosed with lung cancer in 2022.

National Trends in Survival Rates, Early Diagnosis, and Disease Treatment

The State of Lung Cancer report found that the national average for the 5-year survival rate following a lung cancer diagnosis was 25%. Five-year survival rates were highest in Rhode Island at 30.8%, while Oklahoma ranked lowest, at 19.7%.

Nationally, only 25.8% of cases were diagnosed at an early stage, when the 5-year survival rate was at 61%. However, 44% of cases were not caught until a later stage, when the survival rate was only 7%. Early diagnosis rates were highest in Massachusetts, at 31.9%, and lowest in Hawaii, at 19.5%.

Lung cancer screening with annual low-dose computed tomography scans for those at high risk may be capable of reducing the lung cancer death rate by up to 20%. However, nationally, only 5.8% of those at high risk were screened. Massachusetts had the highest screening rate, at 16.3%, while California had the lowest, at 1.0%.

Lung cancer can often be treated with surgery if diagnosed at an early stage and it is nonmetastatic. Nationally, 20.8% of patients with these types of cases underwent surgery as the first course of treatment.

The report indicated that there were multiple reasons why patients did not receive treatment after their diagnoses. Investigators noted that while some of these reasons may be unavoidable, individuals should never go untreated because of a lack of provider or patient knowledge (a stigma often associated with lung cancer), a feeling of fatalism following diagnosis, or the cost of treatment. Nationally, 20.6% of individuals received no treatment after their diagnoses.

The report also highlighted that patients of color who were diagnosed with lung cancer faced worse outcomes compared to White patients—including a lower survival rate, a lesser likelihood of being diagnosed early, as well as a lesser chance of receiving surgical treatment and a greater chance of receiving no treatment at all.

Fee-for-service state Medicaid programs were among the only health-care payers not required to cover lung cancer screenings for high-risk populations. The American Lung Association analyzed lung cancer screening coverage policies in state Medicaid fee-for-service programs to assess the current status of coverage for the Medicaid population and found that 46 states’ Medicaid fee-for-service programs covered lung cancer screenings, 3 programs did not provide coverage, and one state did not have information available on their coverage policy.

The State of Lung Cancer report concluded that states must do more to reduce the burden of lung cancer and encouraged everyone to join the effort to end lung cancer.

Individuals may find out if they are eligible for lung cancer screening at savedbythescan.org.

Disclosure: For additional information on the 2022 State of Lung Cancer report, visit lung.org/solc.