lung cancer

Lung cancer is the number one cause of cancer-related death in the U.S., killing more people than prostate, breast, pancreatic, and colon cancers combined. Although rates of lung cancer incidence and mortality have steadily declined over the past several decades, significant racial and sociodemographic inequities persist across the lung cancer continuum. Disparities are particularly stark between Black and White adults, despite the two groups having similar smoking rates and Black adults having a lower cumulative smoking burden. In fact, Black men have the highest rates of lung cancer incidence and mortality and are more likely to be diagnosed at younger age than White adults, and both Black and Latino individuals are more likely to have late-stage disease when diagnosed.

Reasons for disparities are multifactorial, but largely related to practices and policies rooted in systemic racism and discrimination (e.g., redlining and racially restrictive covenants) that have resulted in minoritized groups and populations of low socioeconomic status (the two often inextricably linked) living in disadvantaged communities characterized by private and public divestment, high rates of unemployment, poverty, and adverse environmental factors, low-quality education and food, and low or no access to high quality health care or preventive services, such as lung cancer screening (LCS). To that end, while LCS rates are staggeringly low across the U.S. at 6% nationally, they are even lower among Black, Latino, and Asian Americans compared to White Americans. A cohort study of American College of Radiology Lung Cancer Screening Registry enrollees showed that the number of eligible individuals screened between 2011-2019 amounts to <12% of the estimated 8 million screen-eligible Americans, and 91.6% of eligible individuals screened were White.

Although the USPSTF expanded LCS eligibility in 2021 by lowering the minimum age and pack-year criteria, at-risk Black Americans remain less likely to meet guidelines than White individuals. Hence, individual risk assessment using an equity lens is critical and, as mounting evidence links various individual and area-level social determinants of health (SDOHs) with increased risk of lung cancer, it is imperative that we account for SDoHs when assessing lung cancer risk and modifying guidelines in the future. Still, it is not enough to merely identify adverse social determinants of health, we must also be compelled to leverage implementation science and community-engaged methods to employ effective, equitable, and scalable strategies that address these issues and translate this work into broader policy and practice changes; this is our goal at Rad Health Equity.

I’m delighted to introduce LungCheck.org, the definitive resource for patients and providers to learn more about lung cancer screening (LCS) and help providers determine patient eligibility, calculate pack-years using our simple and practical pack-year calculator, and order LCS. With the goal of making LCS part of routine clinical care and accessible for all at-risk persons (especially those with the fewest resources), this mobile-friendly website is widely available, clear, concise, and easy to navigate. Check out LungCheck.org, so you can #breatheeasy 🫁 💗