Lung cancer is the second-most common cancer in the United States and the leading cause of cancer-related deaths. An estimated 228,820 people in the country will develop new cases of lung cancer this year, and roughly 135,720 will die from it, according to the American Cancer Society.
“Lung cancer affects people of all races and ethnicities in the United States. However, the burden is greater for many vulnerable populations,” Jeanne Regnante, the chief health equity and diversity officer at the nonprofit organization LUNGevity Foundation, told Healthline.
“Differences have been observed among racial and ethnic minority groups and medically underserved populations: aged populations, rural populations, people with disabilities, low-income groups, LBGTQ, veterans, and immigrant communities,” she continued.
The burden of lung cancer is particularly high for Black Americans, who develop it at higher rates than any other racial or ethnic group in the country.
We spoke with Regnante to learn what’s needed to close the gaps and help diverse communities access the treatment and support they need.
Compared with other racial and ethnic groups in the country, Black Americans are more likely to develop lung cancer and face lower survival rates. Black men are hit particularly hard.
“African American men are 37 percent more likely to be diagnosed with lung cancer than their white counterparts,” Regnante said.
Black Americans of all genders also face disparities in lung cancer diagnosis and treatment.
Those who develop lung cancer are more likely than white patients to be diagnosed at a later stage, after the cancer has spread to distant organs. This makes it harder to treat.
Even when they do receive an early diagnosis, Black Americans tend to have worse outcomes.
The American Cancer Society has reported that from 2008 to 2014, the 5-year relative survival rate for lung cancer in Black people was 16 percent, compared with 19 percent in non-Hispanic whites.
According to Regnante, gaps in lung cancer survival may reflect inequalities in healthcare access, including:
- cancer screening
“The suspected cause for the disproportionately higher mortality is that African American screening rates lag behind other communities,” she said.
“African Americans are also far less likely to be given an opportunity for comprehensive biomarker testing that could put them on a path to be treated with newer, innovative targeted therapies that have been shown to extend life,” she continued.
The authors of a 2016 research review reported that Black patients are 66 percent less likely than white patients to receive timely and appropriate treatment for lung cancer.
Black people with early-stage lung cancer are less likely to have it surgically removed. Those with stage 3 or 4 cancer are less likely to be treated with surgery, chemotherapy, or radiation.
This may partly reflect the fact that Black Americans are more likely than white Americans to be uninsured or lack private health insurance due to long-standing economic inequalities.
Those who live in poorly serviced rural, remote, or low-income areas may need to travel to get cancer screenings, testing, or treatment.
Bias and structural racism in the healthcare system also affect the abilities of racial and ethnic minorities to access timely and high-quality care.
“An abundant volume of research attests that many groups of patients receive a significantly lower quality of care attributable in part to long-held biases of many healthcare providers,” Regnante said.
“Remember, race is not the risk factor — structural racism, not race, is the fundamental cause of racial inequity,” she added.
To close the gaps in lung cancer diagnosis and treatment, system-wide change is needed.
For example, cancer care providers, educators, and advocates need to develop an awareness of their own biases and work to change them, Regnante said.
They need to ask questions and listen to people with cancer to learn about their individual needs, preferences, and interests. And they need to provide patient-friendly education.
“We must earn the trust of these communities by meeting them where they are and asking them what they need and expect,” Regnante told Healthline.
Partnering with community leaders and organizations may also help cancer experts and advocates understand and address the disparities faced by vulnerable communities.
“We know that community engagement is a core function that drives trust, engagement, and access to care with racial and ethnic minority groups and their care partners,” Regnante said.
“We all must invest in, support, include, and ask the advice of trusted community leaders to address disparities. They’re a critical part of the healthcare system,” she added.
Wider changes are also needed to ensure that Americans of diverse backgrounds have access to:
- safe homes and environments
- healthy foods
When it comes to your own health, self-advocacy is important.
If you have lung cancer or you’re at risk of developing it, learning more about your health and taking an active role in healthcare decisions may help you get the care and support you need.
- Ask your healthcare provider if and when you should be screened for lung cancer or other conditions.
- Let your healthcare provider know if you smoke and ask them what resources are available to help you quit.
- Tell your healthcare provider if you have concerns about your health or you develop potential symptoms of lung cancer, such as persistent cough or shortness of breath.
- If you think you might have symptoms of lung cancer or another health condition, ask your healthcare provider about your testing options. Inquire about the benefits, risks, and costs of testing.
- If you have received a diagnosis of lung cancer, ask your healthcare provider about your treatment options — including surgery, radiation, chemotherapy, targeted therapies, and clinical trials. Also find out about the benefits, risks, and costs of each.
- Let your healthcare provider know if it’s difficult for you to afford treatment, travel to appointments, or follow other parts of your recommended treatment plan. Ask them if any resources are available to help you get the care you need.
- If you don’t understand something that your healthcare provider tells you, request that they explain it in different terms. Ask if they have any patient-friendly resources they can share or recommend to help you learn more.
If you don’t think your healthcare provider is taking your concerns seriously or providing you with the care you need, get a second opinion. If you believe your healthcare provider has discriminated against you, consider filing a formal complaint.
A growing number of treatments for lung cancer are available, allowing people with the disease to live longer and with a higher quality of life than ever before
But more work needs to be done to ensure that Americans of all backgrounds can get the diagnosis and treatment support they need.
“To me, the sheer complexity of this topic means that healthcare stakeholders need to work together with one community at a time to address what matters most to patients to get them the trusted resources and access that they need when they need it,” Regnante said.