There’s encouraging information about the lung cancer mortality rate: The numbers are continuing to go down.
According to the latest data from the American Cancer Society, released on Jan. 12, although about one in four cancer deaths in 2019 was among lung cancer patients, mortality rates dropped about 5% each year between 2015 and 2019. Overall cancer mortality decreased about 2% in that same time frame.
This is of course excellent news, but not a cause for celebration. Lung cancer kills more people in the U.S. each year – an estimated 131,880 in 2021 – than the next three cancers combined (colorectal 52,980; breast 43,600; prostate 34,130), accounting for 21.7% of all cancer deaths in this country.
Further complicating matters is a disturbing report published in January by the New York Times stating that cigarettes “have made a comeback with a younger crowd who knows better.”
The “knowing better” part is especially troubling. The vaping/e-cigarettes trend shows no signs of slowing – and we won’t know for certain whether they’re just as bad as regular cigarettes for probably 20 years or so.
It is also important to note that anything irritating the lungs can leave you more susceptible to the adverse effects of COVID-19, which is true of smoking cigarettes and e-cigarettes.
Nevertheless, the downward trend is promising, and reflects the increase in lung cancer screenings nationwide. As with most cancers, early detection is key to successful treatment of lung cancer, with an annual screening one of the means of achieving that. If a person is showing symptoms of lung cancer – persistent coughing, chest pain, shortness of breath, sudden weight loss – it unfortunately is often too late; in fact, the majority of patients who present such symptoms are past the point of effective surgery.
For those who do qualify for surgery, the most commonly performed procedure is a lobectomy, the removal (or resection) of the lobe of the lung affected by the cancer. When successfully performed for early-stage lung cancer, it improves a patient’s chances for long-term survival without recurrence.
An Innovative Approach to Screening
Our Director of Women’s Cancer Program Services, Dr. Cynthia Chin, established an innovative cancer-screening program here about 10 years ago. Then, to qualify for most national studies, participants had to be aged 55 to 75 and be a “30 pack-year” smoker; Dr. Chin changed that at the Hospital to include ages 50 to 79 and 20 pack-year smokers, which has since become the national standard.
(Pack-year is a measure of how much a person has smoked over a period of time, calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. If someone has smoked a pack — 20 cigarettes — a day for the last 30 years, or two packs a day for the last 15 years, they have 30 pack-years.)
It is important to note that, even if someone quit smoking 15, 20, even 30 years ago, they still can develop lung cancer. Again, an annual screening is the best way to detect the disease’s presence. The national standard currently is to screen such patients up to 15 years after they quit; White Plains Hospital goes up to 20 years, and we think it should be even longer.
During a screening, doctors use a low-dose CAT scan (LDCT) of the lungs, with the amount of radiation involved less than what you would be exposed to if you took a cross-country airplane trip.
What do we look for during an LDCT? Besides early – and treatable – early-stage lung cancer, we may detect other abnormalities that indicate the likes of emphysema or coronary artery disease. We may also find various nodules, not all of which will be cancerous.
Again, although the ACS numbers are promising, there is still more work to be done. Doctors should be encouraging annual lung cancer screenings. Government and private payors alike have agreed to pay for the exams – which save more lives than mammograms and colonoscopies. There simply is no reason not to get one.