• Five-year survival rates for lung cancer in the United States have increased over the past five years to 23.7 percent, according to the American Lung Association’s “State of Lung Cancer 2021 Report.”
• Five-year survival rates are lower among minority communities compared to white Americans.
• Lung cancers diagnosed in early stages have a 60 percent five-year survival rate, compared to 6 percent for cancers that have spread widely.

A new report from the American Lung Association found that the national five-year survival rate for lung cancer increased by 14.5 percent to 23.7 percent over the past five years. However, five-year survival rates vary across racial groups and across states. A five-year survival rate refers to the percentage of people who are still alive five years after being diagnosed with a condition.

According to the “State of Lung Cancer 2021 Report,” the five-year survival rate for people of color trails the national rate by nearly 4 percentage points, at 20 percent. The rate for Black Americans trails by nearly 6 percentage points at 18 percent. For Latino Americans and indeigenous people, the rate is 19 percent. Asian Americans and Pacific Islanders have the highest five-year survival rate of 23.4 percent.

The report also found that new cases of lung cancer have decreased 10 percent nationally over the past five years. Lung cancer remains the leading cause of cancer deaths in the United States.

“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,” Harold Wimmer, national president and CEO for the Lung Association, said in a press release.

Survival By Stage

Five-year survival rates for lung cancer vary by stage of diagnosis. Lung cancers that are diagnosed in early stages, before they have spread elsewhere in the body, have a 60 percent five-year-survival rate, according to the State of Lung Cancer report. However, only 24 percent of lung cancers are diagnosed at this early stage. Lung cancers that have metastasized to distant locations have a 6 percent 5-year survival rate according to the report. Nearly half of lung cancers, 46 percent, are diagnosed after the cancer has spread.

Racial Disparities in Lung Cancer

Stage of diagnosis is one factor that contributes to racial disparities in lung cancer survival. A quarter of lung cancers in white Americans are diagnosed at an early stage, compared to 21 percent for Black and Asian Americans and Pacific Islanders and 22 percent for Latinos and indigenous peoples.

Rates of surgical treatment are also lower in Black Americans and amongst indigenous peoples compared to white Americans — 17 percent compared to 21 percent. Surgical treatment rates were the same for Latino and white Americans, and higher in Asian Americans and Pacific Islanders (24 percent). Surgical treatment of lung cancer is most appropriate when the disease is diagnosed before it has spread to other parts of the body. Lower rates of surgery could indicate a pattern of later diagnosis.

People of color are more likely to not receive treatment for lung cancer compared to white Americans. Twenty-one percent of lung cancer cases in white Americans are untreated compared to:

• 26 percent of cases in Latinos
• 23 percent of cases in Black Americans and indigenous peoples
• 22 percent of cases in Asian Americans or Pacific Islanders

The report also notes among the 29 million uninsured people in the United States, half are people of color. A recent report found that cancer diagnoses in the U.S. jump at age 65, suggesting many people wait until they’re eligible for Medicare to receive health care.

“The ongoing effects of systemic racism, inequities and segregation play a role in health disparities overall,” said Zach Jump, national senior director for epidemiology and statistics and research at the American Lung Association, in an email to MyLungCancerTeam.

“These historical inequalities contribute to poor living conditions, including tobacco use, exposures to air pollution, violence, stress, a shortage of primary care physicians in historically underrepresented communities, and lack of access to affordable, quality health care, and nutrition,” Jump added. “These disparities also result in poorer patient outcomes for racial and ethnic groups.”

Disparities Across States

Rates of lung cancer diagnosis and survival rates vary greatly across the United States.

The five states with the lowest rates of new lung cancer cases per 100,000 people in ascending order are:

• Utah — 26.4
• New Mexico — 37.4
• California — 40.6
• Colorado — 40.7
• Wyoming — 42.2

The five states with the highest rates of new lung cancer cases per 100,000 people are:

• Mississippi — 74.3
• Tennessee — 74.4
• Arkansas — 76.9
• West Virginia — 79.3
• Kentucky — 89.4

The states with the highest five-year survival rates are:

• Connecticut — 28.8 percent
• Rhode Island — 28.4 percent
• New York — 27.7 percent
• Minnesota — 27.7 percent
• New Jersey — 27.5 percent

The states with the lowest five-year survival rates are:

• Louisiana — 19.3 percent
• Mississippi — 19.3 percent
• Kentucky — 19.3 percent
• Oklahoma — 18.8 percent
• Alabama — 18.4 percent

The difference in case rate and survival across states may be partially explained by:

• Disparities in the percent of cases diagnosed at early stages
• The percent of high risk individuals being screened for lung cancer
• Smoking rates
• Exposure to radon

Next Steps

The 2021 State of Lung Cancer report is intended to “empower the public to learn more about lung cancer in their state and take action to improve lung cancer patients’ access to quality and affordable health care” and to provide useful information for policymakers, the report concludes.

“Everyone deserves the opportunity to lead a full and healthy life, so more must be done to address these health disparities,” Wimmer said.

The report also includes a call to action to sign a petition, asking Congress to secure $10.5 billion for the Centers for Disease Control and Prevention to help fight lung cancer.