Transforming lung cancer care: A call to increase access to life-saving screening
President Joe Biden speaks on the cancer moonshot initiative at the John F. Kennedy Library and Museum, Monday, Sept. 12, 2022, in Boston. (AP Photo/Evan Vucci)
Mammograms, PSA tests and colonoscopies for early detection of breast, prostate and colon cancers are familiar to us, but many people are not aware of safe and effective screening for lung cancer — a disease that claims the lives of more people than breast, prostate and colon cancer combined. In fact, lung cancer deaths so far this year accounted for 21 percent of all cancer deaths, with colon accounting for 9 percent, prostate 11 percent and breast 15 percent of all cancer deaths.
Current lung cancer screening guidelines recommend low-dose computed tomography (LDCT) for adults who have no symptoms but are at a high risk. This includes adults between 50-80 years old who have smoked the equivalent of a pack a day for 20 years and who currently smoke or have quit smoking within the past 15 years. However, new data shows that only 4.5 percent of eligible Americans are being screened annually for lung cancer — with even lower numbers in underserved communities.
We need to increase lung screening to help us catch cancer earlier, especially as the cure rate for patients diagnosed with stage 1 lung cancer is greater than 70 percent.
Take 77-year-old Marilyn Nesby, a Chicago native who smoked up to two packs of cigarettes a day for 50 years. Due to her long history of smoking, her primary care physician recommended she be screened for lung cancer during a routine check-up five years ago. A simple LDCT test detected a spot on her upper right lung, and an endobronchial ultrasound confirmed it was stage 1 lung cancer. Nesby underwent a minimally invasive procedure to remove the tumor and 10 nearby lymph nodes, which were all clear. Nesby is now living cancer-free.
Early detection saves lives. As many as 60,000 lives could be saved each year if the 14.5 million Americans who are eligible received annual lung cancer screening.
We want to save lives through early detection, and that is why we introduced the Increasing Access to Lung Cancer Screening Act (H.R.4286) — bipartisan legislation to increase lung cancer screening rates nationwide. It is endorsed by leading lung cancer organizations, including LUNGevity Foundation, GO2 for Lung Cancer and the American Lung Association, as well as top cancer institutions such as Moffitt Cancer Center and Roswell Park Comprehensive Cancer Center. The bill would eliminate prior authorization and cost-sharing for lung cancer screening, which are obstacles for many patients, and expand coverage of tobacco cessation therapies in Medicaid. It would also establish a national education and outreach campaign to increase awareness of lung cancer screening and authorize a study to better understand which populations could benefit from screening, such as veterans, firefighters and those exposed to radon either at work or in their homes.
H.R. 4286 aligns with the White House Cancer Moonshot, which calls for expanded access to cancer screening as part of a national effort to end cancer as we know it. As part of the Moonshot, the Health Resources and Services Administration has awarded $10 million to 22 federally qualified health centers across the country to facilitate access to cancer screening and early detection, particularly for underserved populations. Additionally, the Centers for Disease Control and Prevention has issued more than $200 million in grants to support cancer screening programs in every state and many U.S. territories and tribal organizations.
However, too many individuals with lung cancer are diagnosed too late, and we can do better.
While Nesby continues to undergo routine CT scans to watch for recurrence, she now has time to see her grandchildren grow up. We must work harder to ensure lung cancer patients, like Nesby, can live longer. All eligible people deserve the same access to screening. The Increasing Access to Lung Cancer Screening Act would be an important step in achieving our shared vision where lung cancer is diagnosed early and treated effectively.
Brian Higgins represents New York’s 26th District, Brian Fitzpatrick represents Pennsylvania’s 1st District and Kathy Castor represents Florida’s 14th District.