HJNO Jan/Feb 2024

LUNG CANCER SCREENING 26 JAN / FEB 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS Lung cancer continues to be the leading cause of cancer deaths in both men and women in the United States. More people die of lung cancer than colon, breast, and prostate cancers combined. Here in Louisiana, more than 3,800 people are estimated to be diagnosed with lung cancer this year. More than 2,200 are estimated to die from the disease. 1 The burden of lung cancer is not equally shared among states and communities. That’s why, for the past six years, the American LungAssociation has undertaken its “State of Lung Cancer” report, a comprehensive deep dive into the toll lung cancer takes on the people in each state. The report examines rates of new cases, survival, early diagnosis, surgical treatment, lack of treatment, and screening. For the fourth consecutive year, the report explores the lung cancer burden among racial and ethnic groups at the national and state levels. This past November, Lung Cancer Awareness Month, the Lung Association released its 2023 findings. 2 The data confirm that states must do more to protect their residents from lung cancer, including public policy efforts and public health protections. 2023 “State of Lung Cancer” in Louisiana The 2023 “State of Lung Cancer” report found that far too few people in Louisiana are getting diagnosed with lung cancer early, before it has a chance to spread. In fact, the state ranked fifth worst in the nation for early diagnosis (43 out of 47), with an average rate of 23.8%, which is significantly lower than the national rate of 26.6%. The report also revealed health disparities, with Black individuals in Louisiana being least likely to receive surgery as part of the first course of treatment. While surgery may not be an option for every patient, those who receive it as part of their initial treatment have higher survival rates than those who do not. Clearly, more work is needed to reduce the burden of lung cancer in the state. There is a silver lining, however. Lung cancer survival rates are improving for just because the patient has and that the reason lung cancer is so deadly is that by the time patients start experiencing symptoms, it could be too late. Since we launched the “Saved By The Scan”program, lung cancer screening rates among those eligible have increased by 96% nationally. But with Louisiana’s lung cancer screening rate at just 2.7%, there is so much more we can do to create better long-term health outcomes. Dispelling Stigma Lung cancer has another unique and dangerous symptom: stigma. Though lung cancer is the No. 1 cancer killer of men and women, public awareness of the disease is low. Lung cancer does not have nearly the resources, support, and public empathy that many other diseases have. This may have been an unintended consequence of labeling lung cancer as a “smoker’s disease”with the damaging perception that people with lung cancer have brought it upon themselves. We must educate the public on the variety of risk factors for lung disease, including secondhand smoke, radon gas exposure, air pollution, and family history. By reframing lung cancer as a diagnosis that has personal responsibility, we can help decrease the misplaced blame for patients and increase public empathy. We must bring this invisible disease from out of the shadows. Fear, guilt, and blame affect quality of life and quality of care in lung cancer patients. 8 It negatively affects every facet of the lung cancer community — beyond patients and caregivers to physicians, researchers, and funders. The Lung Association is committed to addressing lung cancer stigma, and we’ve conducted ongoing research to better understand and address the problem. Our “Addressing the Stigma of Lung Cancer” report synthesizes much of our findings. 9 In order to tackle lung cancer stigma indefinitely, the lung cancer community needs to change the way it talks about the disease. Through our research on stigma, we’ve identified messaging suggestions for patients, caregivers, and advocates. These everyone, including people of color. In fact, according to our report, the five-year lung cancer survival rate for people of color has increased by 17% in the last two years, helping close the health disparity gap. 3 But there is more to do. And this is where healthcare providers in Louisiana come in. Low-Dose CT Scan When lung cancer is caught early, the five-year survival rate improves to 63%. 4 Screening with annual low-dose CT scans among those at high risk can reduce the lung cancer death rate by up to 20% by detecting tumors at early stages when they are more likely to be curable. 3 Yet only 2.7% of eligible Louisiana residents were screened in 2022, which is significantly lower than the national rate of 4.5%. 3 Based on new research, in March of 2021, the United States Preventive Services Task Force expanded its recommendation for screening to include a larger age range and more current and former smokers. This will dramatically increase the number of women and BlackAmericans considered at high risk for lung cancer. 5 Currently, the high-risk guidelines are: • Age: 50-80 years. • Smoking history: 20 or more pack years (this means 1 pack a day for 20 years, 2 packs a day for 10 years, etc.). • Smoking status: current smoker or quit within the last 15 years. 6 “Saved By The Scan” On World Lung Cancer Day in 2017, the Lung Association, in partnership with The Ad Council, launched the first-of-its-kind, national lung cancer screening campaign, “Saved By The Scan.” 7 Many people aren’t aware of low-dose CT scans and don’t know that they’re quick, painless, and safe. The campaign features a lung cancer screening eligibility quiz that helps people understand their risk and empowers high- risk individuals, i.e., current or former smokers over the age of 50, to discuss lung scans with their healthcare providers. We know that lung cancer doesn’t quit