Dermatologic Manifestations of Paraneoplastic Syndromes

Many US Lung Cancer Patients Not Receiving Treatment

Although lung cancer survival is improving in the United States, 21% of patients with lung cancer did not receive treatment in 2021, according to data from the American Lung Association's State of Lung Cancer 2024 Report.1

As of 2021, the 5-year survival rate after a lung cancer diagnosis was 28.4% nationally, which is a 26% improvement from 2017. The rate of early lung cancer diagnosis has improved as well, increasing 11% from 2017 to 2021.

In 2021, 43% of patients diagnosed with lung cancer had distant metastasis at diagnosis, 27% had early-stage disease, 22% had regional spread, and 8% had unstaged tumors. The 5-year survival rates for these patients were 9%, 64%, 36%, and 16%, respectively.

The report suggests that early diagnosis of lung cancer is more likely among White people than among people of other races and ethnicities. In 2021, Latino and Asian/Pacific Islander people were 17% less likely than their White counterparts to be diagnosed early. Early diagnosis was 15% less likely for Black people and 12% less likely for Indigenous people than for White people.

Black people were 16% less likely than White people to survive for 5 years after a lung cancer diagnosis, and Indigenous people were 15% less likely to survive for 5 years. Latino and Asian/Pacific Islander people were as likely as White people to survive for 5 years after diagnosis.

Overall, 20.9% of patients with lung cancer received no treatment in 2021. A lack of treatment was 30% more likely among Latino patients than among White patients, 20% more likely among Indigenous patients, and 12% more likely among Black patients. A lack of treatment was equally likely among Asian/Pacific Islander patients and White patients.

The report did not include data on most types of treatment patients received but did note a lack of insurance coverage for biomarker testing used to guide treatment decisions. As of August 2024, 30 states and Washington, DC, did not require insurance companies to cover the cost of biomarker testing. Fifteen states required insurance to cover the entire cost, and 5 states required insurance companies to cover some of the costs.

The report also noted that, although a change in lung cancer screening recommendations in 2021 "dramatically increased the number of women and Black individuals who are considered at high risk for lung cancer," there is still a lack of screening in high-risk people. In 2022, 16% of people considered high risk were screened.

"More people with lung cancer are living longer, and that is something to celebrate. However, lung cancer is still the leading cause of cancer deaths in the US," Harold Wimmer, president and CEO of the American Lung Association, said in a statement.2 "Increasing lung cancer screening rates and expanding biomarker testing are enormous opportunities to catch cancer earlier and provide the best treatments for people diagnosed with the disease."

Disclosures: This research was supported by the American Lung Association.

Can Lung Cancer Be Prevented? Identify The Risk Factors And Survival Rates

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2024 'State Of Lung Cancer' Report: 7 Takeaways

The American Lung Association released its 2024 "State of Lung Cancer" report, highlighting a 26% increase in survival and a 15% decrease in incidence, though care disparities across state lines and demographics are still influencing patient outcomes.

The report includes national and state level data on lung cancer screening, diagnosis, survival, treatment trends and disparities in care, according to a Nov. 19 news release from the association. 

Here are seven takeaways from the report:

Survival: The national lung cancer survival rate has increased by 26% over the past five years to 28.4%. Massachusetts had the highest survival rate at 37.9% and Oklahoma had the lowest at 22.2%. The five-year survival rate for lung cancer is 64% when diagnosed at an early stage, compared to 9% for late stage diagnoses.

Diagnosis: About 235,000 people will be diagnosed with lung cancer in the U.S. This year. Nationally, 27.4% of lung cancer cases are diagnosed at an early stage and 43% are diagnosed at a late stage.

The national early diagnosis rate increased 11% over the last five years. Massachusetts had the highest early diagnosis rate at 34.7% and Hawaii had the lowest at 21.1%.

Screening: Nationally, 16% of high risk individuals received lung cancer screening. Rhode Island had the highest screening rate at 28.6% and Wyoming had the lowest at 8.6%.

Treatment: Of all lung cancer cases in the U.S., 20.9% received no treatment after diagnosis. Lack of treatment rates were highest in Nevada at 36.7% and lowest in Massachusetts at 13.2%.

Nationally, 20.7% of diagnosed lung cancer cases were treated with surgery. Massachusetts had the highest rate of surgical treatment at 31.8% and New Mexico had the lowest at 13%. Surgical treatment rates decreased by 2% in 2021, which the report attributes to the COVID-19 pandemic.

Biomarker coverage: Comprehensive biomarker testing is used by physicians to determine the most effective form of treatment for lung cancer, though insurance coverage for the testing varies by state.

As of August 2024, 15 states required complete coverage of biomarker testing, 5 states required some coverage, and 30 states and Washington, D.C. Had no coverage requirements.

Incidence: The rate of new lung cancer cases has decreased nationally by 15% over the last five years to 53.6%. Utah had the lowest incidence rate at 25.2% and Kentucky had the highest at 84.9%.

Disparities: In the U.S., people of color are less likely to receive an early stage lung cancer diagnosis, more likely to not receive any treatment and less likely to receive surgical treatment after diagnosis.

Read the full report here.

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