November is Lung Cancer Awareness Month. Lung cancer is by far the leading cause of cancer death for both men and women. Each year, more people die of lung cancer than colon, breast and prostate cancers combined.
Cigarette smoking is the top risk factor for lung cancer, with the Centers for Disease Control estimating more than 80% of all cases are caused by tobacco use. Unfortunately, about 70% of lung cancer cases are diagnosed at an advanced stage when survival rates are low.
UC Davis Comprehensive Cancer Center is committed to improving access to lung cancer screening.
Low-dose computed tomography, known as a CT scan, is key for identifying lung cancer early. But screening rates are shockingly low in California. Only 1% of those at high risk of lung cancer are getting screened, which is significantly lower than the national rate of 6%. In fact, the screening rate in California is in the bottom tier of the country, according to the American Lung Association (ALA) State of Lung Cancer report.
Lung cancer is the poster child for health disparities
Lung cancer is particularly devastating in communities of color. The ALA reports that, compared to white Americans, Black Americans with lung cancer are:
- 18% less likely to be diagnosed early
- 23% less likely to receive surgical treatment
- 9% more likely to not receive any treatment
- 21% less likely to survive five years, compared to white Americans
New lung cancer screening guidelines recommended by the U.S. Preventive Services Task Force will help address health disparities and catch more cases of lung cancer, earlier.
Under new lung cancer screening guidelines, updated in 2021, anyone between the ages of 50 and 80 who has smoked at least 20 "pack-years" and either still smokes or quit within the last 15 years will be eligible.
A "pack-year" is calculated by multiplying the number of packs a day someone smoked during the years they smoked the most by the number of years they smoked. For example, someone could qualify by smoking pack a day for 20 years or two packs a day for 10 years. Prior to the updated guidelines, low-dose CT scans were only recommended for heavier smokers (30 pack-years), starting at age 55.
Black Americans, women and younger people with lung cancer tend to smoke less, which means they often did not meet the former screening thresholds, despite being at risk for lung cancer. The updated task force recommendations correct for this. The updated guidelines also mean private insurers must offer the screening without a copay to those who are eligible.
"More Black smokers and women will be eligible," said David Tom Cooke, chief of the UC Davis Health Division of General Thoracic Surgery. "The new guidelines are not a panacea because actual screening rates, especially among communities of color, are needlessly low, but the new guidelines will no doubt save more lives."
Symptoms of lung cancer
Lung cancer is often identified before symptoms occur, but some people with early lung cancer may experience symptoms.
- A cough that does not go away or gets worse
- Coughing up blood or rust-colored sputum (spit or phlegm)
- Chest pain that is often worse with deep breathing, coughing, or laughing
- Hoarseness
- Loss of appetite
- Unexplained weight loss
- Shortness of breath
- Feeling tired or weak
- Infections such as bronchitis and pneumonia that don't go away or keep coming back
- New onset of wheezing
"Go to your doctor when you first notice anything. If cancer is diagnosed at an earlier stage, treatment is most effective," Cooke said.
Scan and quit
"It is easier than ever to get screened for lung cancer," Cooke said. "To save lives, we need eligible smokers and former smokers to accept that they are at risk and get screened."
Go to Comprehensive Lung Cancer Screening Program
