By Amy Yurkanin
Alabama had the lowest five-year survival rate for lung cancer out of 45 states included in a report released last month by the American Lung Association.
The report also found lower survival rates nationwide for Black patients. People of color were less likely to receive early diagnoses or receive surgical treatment than white patients, according to the association.
In Alabama, only 18.4 percent of lung cancer patients survived five years after diagnosis, compared to 23.7 percent nationally. Connecticut had the highest five-year survival rates at 28.8 percent. The five-year survival rate for lung cancer has increased nationally by 14.5 percent, but rates among minorities still lag.
“While we celebrate that more Americans are surviving lung cancer, too many people are being left behind, and the disease remains the leading cause of cancer deaths,” said Ashely Lyerly, director of advocacy for the American Lung Association. “With Alabama having the worst lung cancer survival rate in the nation, it’s clear much more can and must be done to prevent the disease and support those facing the disease, like passing comprehensive smoke free laws and making sure that everyone who is at high risk is screened for lung cancer.”
Lung cancer is the deadliest type of cancer because it is often detected at later stages when treatments become less effective, according to the association. Recent changes to screening guidelines have widened the range of people eligible for annual scans that could detect lung cancer in its earliest stages.
Dr. Hitesh Batra, director of interventional pulmonology at UAB, said the percentage of patients receiving scans for lung cancer has stalled at less than 5 percent in Alabama.
“There’s a lot of room for improvement here,” Batra said. “The more people we screen, the more lives we save.”
The guidelines say people between the ages of 50 and 80 who smoke or quit within the last 15 years should receive annual low dose computed tomography scans. The screenings carry some risk, which is why they are only recommended for people at high risk for disease. Smoking is the largest risk factor for lung cancer, but the disease can also be caused by secondhand smoke and exposure to radon, an odorless gas often detected inside of buildings.
The Alabama Department of Public Health operates a Quit Line to assist smokers who want to stop. The number is 1-800-QUIT- NOW.
For 2021, the Alabama Department of Public Health estimates that about 2,860 people in the state will die from lung cancer, far outpacing any other form of the disease. The second deadliest type of cancer, colon cancer, is expected to kill 920 people.
“The problem with lung cancer is that it doesn’t cause any symptoms in the early stage of the disease,” Batra said. “There are no nerve endings in the lungs. So it’s only at the later stage of the disease that you’ll have any symptoms, but by that time you find that the lung cancer is advanced.”
The incidence rate for lung cancer in Alabama is much higher than the national average. Men are more likely to be diagnosed with the disease than women, and Black men have the highest rates.
A number of different factors could contribute to higher lung cancer death rates among Black patients in Alabama, Batra said. Smoking rates are higher in some communities, and others may be exposed to pollution or other environmental factors. Other patients may face barriers to health care and struggle to obtain recommended scans.
According to the U.S. Centers for Disease Control and Prevention, Alabama has one of the highest adult smoking rates in the country at more than 20 percent.
Gov. Kay Ivey announced in 2019 that her doctor found a cancerous spot on her lung. Unlike most cases, hers was caught at an early stage a treated with radiation at UAB. In January 2020, she released an update on her condition. In it, her doctor said he considered Ivey to be cured.
Batra said there are two key elements to improving lung cancer survival rates in Alabama.
“The targets that will actually have substantial benefits for survival from lung cancer are, one, decreasing smoking rates and, two, increasing screening,” Batra said.