About 1 in 15 men and 1 in 17 women develop lung cancer at some point in their lives. However, certain lung cancer risk factors can increase or decrease a person’s chances of being diagnosed with this type of cancer.

One risk factor is ethnicity (race). People of different races tend to develop lung cancer at different rates. Sometimes, this may be due to inherited gene changes that are passed down within families. More often, racial differences are related to environmental factors, such as where a person lives or works.

Experts use the term “health disparities” to describe preventable differences in disease or health between different groups of people.

Lung Cancer Risk Among Different Racial or Ethnic Groups

Researchers often measure lung cancer rates by reporting how many people get the disease within a group of 100,000 people. Overall within the United States, there are 60.1 lung cancer cases per 100,000 men, and 47.9 lung cancer cases per 100,000 women each year.

These numbers vary based on race. Lung cancer rates for different racial and ethnic groups are as follows:

• White — 60.5 cases per 100,000 men and 47.9 cases per 100,000 women
• African American — 69.3 cases per 100,000 men and 43.3 cases per 100,000 women
• Asian/Pacific Islander — 45.0 cases per 100,000 men and 28.7 cases per 100,000 women
• American Indian/Alaska Native — 40.9 cases per 100,000 men and 35.5 cases per 100,000 women
• Hispanic — 34.4 cases per 100,000 men and 24.6 cases per 100,000 women
• Non-Hispanic — 63.6 cases per 100,000 men and 51.2 cases per 100,000 women

Lung Cancer Outcomes

People with lung cancer also tend to have different outcomes based on race. For example, compared to white individuals:

• African Americans are 21 percent less likely to live for five years or more after a lung cancer diagnosis.
• Latino individuals are 16 percent less likely to live at least five years.
• Asian Americans or Pacific Islanders are 9 percent more likely to live for five years after developing lung cancer.
• American Indians or Alaska Natives are 13 percent less likely to live at least five years.

Researchers have proposed a couple of reasons why survival rates vary. Some have offered genetic or dietary lifestyle explanations. Most now believe that these racial disparities are often caused by differences in access to care, rather than biology or genetics.

For example, there are inequalities in which lung cancer treatments are used by people of different races or ethnicities. African Americans are 9 percent more likely to not receive treatment and 23 percent less likely to undergo surgery than white individuals. Meanwhile, Latinos are 26 percent more likely to not undergo treatment for lung cancer.

Increasingly, doctors are using individualized treatment plans for people with lung cancer. They may give specific medications based on a person’s exact cancer-causing gene changes. Doctors know which treatments are likely to work best based on clinical trials. However, these clinical trials have been conducted mostly in the white population. Doctors may not know whether individualized treatments will work as well in people of color.

Factors That May Affect Lung Cancer Risk

Many different risk factors can play a role in whether a person develops lung cancer. Some of these factors are more common in people of certain races or ethnicities.

Smoking

Smoking cigarettes is the number one cause of lung cancer. Studies have found some differences in smoking habits among people of different races. However, these differences don’t always fully explain the contrasting lung cancer rates.

Smoking rates are highest among those who are American Indians, Alaskan Natives, or multiracial, and lowest among Hispanic individuals. This could explain some of the differences regarding who is likely to be diagnosed with lung cancer. However, the link between smoking rates and lung cancer rates is less clear among African Americans.

Studies have found that, compared to white men, African American men are generally more likely to start smoking later in life and to smoke fewer cigarettes per day. Researchers say that these factors should mean that African American individuals are less likely to develop cancer.

Additionally, among groups of white men and African American men who smoke at the same rate, African American and Native Hawaiian individuals are still more likely to be diagnosed with lung cancer. Researchers speculate that this could be because African American individuals are more greatly affected by the chemicals found in cigarette smoke.

On the other hand, African American individuals are less likely to quit smoking and tend to smoke for more years than people of other races. These factors lead to a higher risk of lung cancer.

Overall, researchers believe that differences in smoking habits could partly explain the contrasting lung cancer rates between different racial groups. However, they don’t appear to be the only factor. African American nonsmokers are more likely to develop cancer than white nonsmokers, however, other factors may be involved.

Lung Cancer Screening

Experts recommend lung cancer screening tests for people who have a history of smoking. These tests can help detect lung cancer early, leading to better outcomes.

One widely accepted recommendation for annual lung cancer screening is using a low-dose CAT scan in adults aged 55 to 80 years who have a 20-pack-year smoking history and currently smoke or have quit within the past 15 years. (A pack-year describes the number of packs of cigarettes a person has smoked per day, multiplied by the number of years they have smoked.) Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to undergo curative lung surgery.

Studies have found that the guidelines describing who is eligible for screening lead to health disparities. Because people of color are more likely to develop lung cancer after smoking the same amount as white individuals, people of color need increased access to screening tests. Under the current guidelines, African American, Hispanic, and Asian or Pacific Islander individuals aren’t eligible for screening until their lung cancer risk level is higher than that of white individuals.

Geography, Pollution, and Access to Health Care

There are different rates of lung cancer in different countries and within different states in the United States. There are a couple of possible explanations. First, pollution may play a role. Recent research has found that pollution is the second leading cause of lung cancer, accounting for 14 percent of lung cancer cases throughout the world.

Pollution-linked lung cancer tends to be more common in low-income countries. However, within the United States, pollution levels are often higher in neighborhoods where minority groups live. This environment may lead to a higher risk of lung cancer for the people who live in these communities.

Other geographical factors are also linked to lung cancer disparities. One recent study found that states in the southeastern part of the United States had the highest lung cancer death rates. Researchers said that lung cancer screening access affected this result. The places with the highest death rates were often the places that screened the fewest people. Individuals who live in certain parts of the country are less likely to have a nearby health care facility that offers screening services.

Workplace Risk Factors

In some jobs, workers are exposed to chemicals that could damage the lungs. Harmful chemicals include arsenic, silica, asbestos, uranium, nickel, cadmium, chromium, and petroleum.

In one large study, African American individuals were more likely to work at jobs where they were exposed to these chemicals. Researchers concluded that this could play a role in the higher rates of lung cancer seen in African Americans.

Genetics

Lung cancer is sometimes caused by gene changes that are inherited (passed from parent to child). People of any race who have a close relative with lung cancer are more likely to be diagnosed with this condition.

Researchers have identified a few different gene mutations that can increase lung cancer risk. However, many studies have not yet found that these mutations are more likely to occur in people of certain races. A few studies have found that certain gene changes linked to lung cancer are more or less likely to occur in individuals who live in Asian countries compared to those who live in Western countries. More research is needed to understand how genetics can affect lung cancer risk in people of different races.

Talk With Others Who Understand

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