• Earlier detection of lung cancer is improving five-year survival rates.
• Despite advances, lung cancer remains the leading cause of cancer-related death in the United States.

New advances in early detection and treatment are improving survival rates for people with cancer — particularly for those living with lung cancer — according to the annual Cancer Statistics report from the American Cancer Society.

The five-year survival rates for all cancers combined was 68 percent, a notable improvement from 49 percent in the 1970s. Part of this improvement has been a nationwide effort to increase early detection of cancer.

Lung cancer still remains the number one cause of cancer-related death in the United States. However, advances in lung cancer screening and access to care have allowed for earlier detection. Nearly 31 percent of people with lung cancer are still living three years after diagnosis, up from only 21 percent in 2004.

The American Cancer Society report highlights a combination of factors leading to improved survival, including new treatments, access to medical care, and expanded coverage for early screening.

Lung Cancer Diagnosis and Survival

Early diagnosis of lung cancer is known to improve survival rates. The five-year survival rate for localized disease is 60 percent, while regional-stage disease is 33 percent and distant disease is 6 percent, according to the report. Nearly 28 percent of lung cancers in 2018 were detected when the disease was localized, the earliest stage of the disease. In contrast, in 2004, only 17 percent of lung cancers were detected at a localized stage.

These statistics highlight the growing efforts to improve early and accurate diagnosis. In light of these efforts, in March 2021, new recommendations were made to expand screening efforts to all individuals over the age of 50 who have a 20 pack-year history of smoking.

The median survival after lung cancer diagnosis improved from 8 months to 13 months in 2017. This increase in survival is attributed to a combination of earlier detection and improved treatment options.

Unfortunately, the mortality rate of lung cancer remains significant. Lung cancer-related deaths exceed the deaths related to breast, prostate, and pancreatic cancers combined. However, these numbers are steadily dropping. The changes in lung cancer mortality are most likely connected to trends in cigarette smoking, which has steadily decreased over time. Currently, more than 80 percent of lung cancer cases are linked to cigarettes.

Sex and Racial Disparities in Cancer

The Cancer Statistics report highlights differences in cancer based on sex and race. Men were more likely than women to be diagnosed with cancer, 40.2 percent versus 38.5 percent, respectively. The most common cancer diagnoses overall were prostate, lung, and colon cancers for men. For women, the most common cancer diagnoses were breast, lung, and colon cancer.

The report makes particular mention of the racial disparities in cancer detection and treatment in the U.S. Black women have an increased risk of dying of cancer — 12 percent more likely than white women. Similarly, Black men carried a higher risk than white men of developing cancer or dying from it. While these differences are stark, there have been improvements over the past few decades.

The Black-white disparity in overall cancer mortality was as high as 33 percent in 1993 and decreased to 14 percent as of 2019. Although promising, the report highlights the ongoing need for improvement of persistent racial, socioeconomic, and geographic disparities that contribute to cancer outcomes.

Treatment Advances

The report also highlights recent advances in the treatment for lung cancer. These include the approval in 2014 of new treatments that target specific lung cancer driver mutations, such as epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK). In addition, checkpoint immunotherapies and video-assisted thoracoscopic surgery (VATS) are also driving improvements in lung cancer survival rates.