New Report: Lung Cancer Survival Rate Improves, But Gaps in Biomarker Testing and Lack of Screening Hinder Progress

Lung cancer is the leading cause of the cancer deaths in the U.S., but the American Lung Association’s 2024 “State of Lung Cancer” report reveals positive news. The lung cancer survival rate has improved 26% in the last five years. The report also presents opportunities for states to further improve lung cancer survival by increasing access biomarker testing, and for the federal government to work to increase access to screening.

The organization’s seventh annual “State of Lung Cancer” report highlights how the toll of lung cancer varies by state and examines key indicators throughout the U.S. including new cases, survival, early diagnosis, surgical treatment, lack of treatment, screening rates and insurance coverage of comprehensive biomarker testing.

“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 U.S.,” said Harold Wimmer, President and CEO of the American Lung Association. “This year’s ‘State of Lung Cancer’ report provides a path for states and the federal government to take to improve the lives of people living with this devastating disease. 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. There is more work to do, but I am incredibly optimistic about the future of lung cancer care.”

New this year, “State of Lung Cancer” examines insurance coverage of comprehensive biomarker testing across the U.S. Lung cancer biomarker testing, sometimes referred to as tumor, molecular, genomic or genetic testing, looks for changes in the tumor's DNA. The results of the test may show biomarkers that can help determine what treatment options would be best for an individual patient. Insurance coverage of biomarker testing is important for removing a cost barrier to people with lung cancer, but coverage for biomarker testing is only required in some states. The report found that only 15 states require insurance coverage of comprehensive biomarker testing, five states require some plans to cover testing, and 30 states and Washington, D.C. have yet to require any coverage of biomarker testing.

The report also closely tracks lung cancer screening nationally and by state. In 2023, only 16% of those eligible were screened nationally. Rhode Island has the best screening rating at 28.6%, while Wyoming has the worst at 8.6%. Note that this year, the Lung Association used a new data source for lung cancer screening rates, so they cannot be compared to previous “State of Lung Cancer” reports.

Close to 235,000 people in the U.S. will be diagnosed with lung cancer this year. In addition to screening rates and state health coverage of comprehensive biomarker testing, which were discussed above, the 2024 “State of Lung Cancer” report found the following national trends in survival rate, early diagnosis, surgery, lack of treatment and health disparities:

• Survival Rate: Lung cancer has one of the lowest five-year survival rates because cases are often diagnosed at later stages, when it is less likely to be curable. The national average of people alive five years after a lung cancer diagnosis is 28.4%. Survival rates were best in Massachusetts (37.9%) and worst in Oklahoma (22.2%).
   
• Early Diagnosis: Nationally, only 27.4% of cases are diagnosed at an early stage when the five-year survival rate is much higher (64%). Unfortunately, 43% of cases are not caught until a late stage when the survival rate is only 9%. Early diagnosis rates were best in Massachusetts (34.7%), and worst in Hawaii (21.1%).
   
• Surgery as First Course of Treatment: Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread. Nationally, 20.7% of cases underwent surgery. Surgical treatment rates decreased by 2% in 2021, likely due to the impact of the COVID-19 pandemic on utilization of medical care.
   
• Lack of Treatment: There are multiple reasons why patients may not receive treatment after diagnosis. Some of these reasons may be unavoidable, but no one should go untreated because of lack of provider or patient knowledge, stigma associated with lung cancer, fatalism after diagnosis or cost of treatment. Nationally, 20.9% of cases receive no treatment. Lack of treatment rates were highest in Nevada (36.7%), and lowest in Massachusetts (13.2%).
   
• Health Disparities: The report also highlights that people of color who are diagnosed with lung cancer face worse outcomes compared to white individuals. According to “State of Lung Cancer,” people of color who are diagnosed with lung cancer are less likely to be diagnosed early, less likely to be alive five years after diagnosis, less likely to receive surgical treatment and more likely to receive no treatment. More must be done to eliminate lung cancer health disparities.

The 2024 “State of Lung Cancer” report highlights opportunities for states and the federal government to reduce the burden of lung cancer and encourages everyone to help end lung cancer. This year, the American Lung Association calls for all states to implement policies to require insurance coverage of comprehensive biomarker testing. The Lung Association also calls on Congress to pass the Increasing Access to Lung Cancer Screening Act (H.R. 4286).

Learn more about “State of Lung Cancer” at Lung.org/SOLC.