By Pat Carragher - November 22, 2021
The American Lung Association’s 2021 “State of Lung Cancer” report shows that Florida ranks among the states with the lowest lung cancer screening rates. According to the report, only 3% of Floridians considered to be at high risk for lung cancer have received a low-dose CT scan, compared to the national rate of 6%.
The annual report looks at 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 and screening rates.
According to the report, Florida ranked:
22nd in the nation for lung cancer incidence at 57.3 per 100,000
Incidence refers to the number of new cases of lung cancer in each state. The national lung cancer incidence is 57.7 per 100,000.
12th out of 45 (for which data is available) in the nation for survival at 25.3% (above average)
The national average of people alive five years after a lung cancer diagnosis is 23.7%.
35th out of 49 in the nation for early diagnosis at 23.7% (average)
Nationally, only 24.5% of cases are diagnosed at an early stage when the five-year survival rate is much higher.
41st in the nation for lung cancer screening at 3% (below average)
Lung cancer screening with annual low-dose CT scans for those at high risk can reduce the lung cancer death rate by up to 20%. Nationally, only 5.7% of those at high risk were screened.
19th out of 49 in the nation for surgery at 20.7% (average)
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.
42nd out of 49 in the nation for lack of treatment at 25% (below average)
Nationally, 21.1% of cases receive no treatment. Florida ranked among the worst in this category.
In Florida, Black Americans are least likely to receive surgical treatment for their lung cancer.
“We really need to educate providers and patients about lung cancer screenings because the rates are not even close to where they should be,” said Dr. Bruna Pellini, a thoracic oncologist at Moffitt Cancer Center. “The earlier we know, the higher the chance we have of a cure.”
While the findings show significant room for improvement, there is hope. Earlier this year the United States Preventive Services Task Force expanded its recommendation for screening to include a larger age range and more current or former smokers. This dramatically increased the number of women and Black Americans who are eligible for lung cancer screening.
Dr. Ben Creelan, a thoracic oncologist at Moffitt, recently discussed the report during The Atlantic’s 2021 People v. Cancer virtual summit. Creelan said that while a lung cancer diagnosis is no longer the death sentence that it used to be thanks to modern advancements in treatments, the need for providers to push for screenings can’t be understated.
“If you’re in primary care, you have 15 minutes to see one patient. Explaining how to do lung cancer screening is not the top priority during a visit because there is always going to be different things going on,” said Creelan. “I think if our payers could incentivize this among primary care the same way they incentivize colonoscopy, mammogram or cardiac screening, that would make the biggest difference.”
"I think if our payers could incentivize this among primary care the same way they incentivize colonoscopy, mammogram or cardiac screening, that would make the biggest difference."- Dr. Ben Creelan, thoracic oncologist
A 2019 study of targeted incentive programs found that if insurance payers incentivized lung cancer screening among primary care, it could save 12,300 life-years and save our health system over $771 million.