Lung Cancer (LC)

Lung Cancer

In the US, lung cancer is the leading cause of cancer death for Americans.

Almost 240,000 new cases of lung cancer were diagnosed in 2023. But lung cancer does not impact Americans equally:

More women are diagnosed with lung cancer than men, despite women smoking less than men.
Asian American never-smokers (known as people who have smoked 100 or less cigarettes in their lifetime) have the highest incidence of lung cancer compared to any other racial or ethnic group.
Black/African Americans get and die from lung cancer more often than any other ethnic group.
Amongst Hispanic Americans who are eligible for lung cancer screening, only 2% are getting screened.

Underrepresented communities are at increased risk

Asian American Community

Asian American Never-smokers Face Major Health Disparities in Lung Cancer.

Asian American never-smokers (people who smoke 100 or less cigarettes during their life), especially Asian females, have the highest incidence of lung cancer compared to any other racial or ethnic group of never-smokers.
Asian American never-smokers get lung cancer almost 2x as often as white never-smokers
30% to 40% of all Asian Americans with non-small cell lung cancer (NSCLC) have genetic mutations (gene changes), called EGFR mutations are a main cause of lung cancer in Asian Americans who never smoke.

It is important for Asian American lung cancer patients to self-advocate for genetic testing. While testing for lung cancer mutations does not reduce your risk for lung cancer, genetic testing can help identify the best treatment that will work for your type of lung cancer.

If you have been diagnosed with lung cancer and are interested in learning more about genetic testing or mutations in lung cancer, contact a CHM Patient Navigator here.

Unfortunately, Asian American never-smokers fall outside the U.S. lung cancer screening guidelines, which primarily target smokers. This can lead to lung cancer being diagnosed at later stages when it is more difficult to treat.

Low Awareness of Lung Cancer Screening Amongst Asian Americans

Studies have found low awareness of lung cancer screening guidelines among Asian American smokers and physicians caring for these communities. If you smoke or have regularly smoked in the past, getting a low dose CT scan (LDCT) every year can save your life.

There are many smoking cessation programs to help you stop smoking. Do it for you and the family and friends who love you.

It is important for Asian Americans to be aware of their lung health and get checked by a knowledgeable lung doctor (Pulmonologist) if experiencing any lung cancer symptoms, such as a long-lasting cough that does not go away.

When caught early, lung cancer is treatable, and may be cured. Increased awareness about lung cancer risk factors and lung cancer symptoms, especially for never-smokers, is key.

Asian American Community

African Americans get and die from lung cancer more often when compared to other racial group. Health disparities impacting our community are:

Higher rates of smoking: African Americans have historically had higher rates of smoking compared to white Americans.
Exposure to lung toxins
Late diagnosis and delays in treatment: A late diagnosis leads to a lower survival rate, and less chance for a cure.
Black/African Americans with early-stage lung cancer are less likely to receive surgery that may cure their lung cancer, when compared to white patients.

Higher Prevalence of Certain Genetic Mutations in African American Lung Cancer Patients

There is a higher prevalence of certain genetic mutations in the African American community, such as KRAS and MET, when compared to white Americans. It is important for the African American community to advocate for genetic testing if diagnosed with lung cancer. While identifying lung cancer mutations does not reduce your risk for lung cancer, genetic testing can help identify the best treatment that will work for your type of lung cancer.

If you have been diagnosed with lung cancer and are interested in learning more about genetic testing or mutations in lung cancer, contact a CHM Patient Navigator here.

Low Lung Cancer Screening in the African American Community

Less than 9% of eligible African Americans received low-dose CT (LDCT) screening. That means over 91% of African Americans are eligible, but do not seek screening for lung cancer. If you have health insurance, this test should be covered at no cost to you.

If you do not have health insurance, the average cost for a low-dose CT scan may be $250 but varies depending on the imaging center where the scan is done. There are some Community Centers that offer lung cancer screening at reduced rates, or at no cost at all.

If you smoke, there are many smoking cessation programs to help you stop smoking. Do it for you and the family and friends who love you.

When caught early, lung cancer is treatable and may even be cured. Increased awareness about lung cancer risk factors and getting a low-dose CT scan can save your life.

Hispanic American Community

Studies have shown that Hispanic lung cancer patients have a delay of more than 2 months from diagnosis to starting treatment. Such delays can lead to worsened outcomes for the Hispanic community. Also, Hispanic Americans with early-stage lung cancer are less likely to receive surgery, which is the best option for a cure, when compared to white Americans.

Higher Prevalence of Certain Genetic Mutations in Hispanic American Genetic Lung Cancer patients

Some studies show that there is a higher prevalence of certain genetic mutations in the Hispanic American community, such as EGFR, ALK, ROS-1, and MET, when compared to white Americans. It is important for Hispanic Americans to advocate for genetic testing if diagnosed with lung cancer. While testing for these lung cancer mutations does not reduce your risk for lung cancer, genetic testing can help identify the best treatment that will work for your type of lung cancer.

If you have been diagnosed with lung cancer and are interested in learning more about genetic testing or mutations in lung cancer, contact a CHM Patient Navigator here.

Low Lung Cancer Screening Rates Amongst Hispanic Americans

Only 2% of eligible Hispanic Americans received low-dose CT (LDCT) screening. That means almost 98% of Hispanic Americans are eligible but do not seek yearly screening for lung cancer. If you have health insurance, this test should be covered at no cost to you.

If you smoke, there are many smoking cessation programs to help you stop smoking. Do it for you and the family and friends who love you.

When caught early, lung cancer is treatable, and may be cured. Increased awareness about lung cancer risk factors and getting a low-dose CT scan can save lives.

Lung Cancer in People Who Have Never Smoked

Many people mistakenly believe that if they have never smoked, they will not get lung cancer. The truth is 10-20% of all lung cancers occur in “never-smokers”.

While it is commonly known that smoking cigarettes is the major risk factor for lung cancer, there are other risks for never-smokers to get lung cancer:

Secondhand cigarette smoke exposure
Exposure to certain chemicals or substances:
- Radon, potentially found in buildings with little ventilation or basements and lower floors.
- Asbestos, found in buildings built before the 1980s or industries that manufactured or used fireproof materials such as automotive parts, shipbuilding, textiles, power plants, mining, and firefighter equipment. Today, asbestos use is heavily regulated.
- Arsenic, Chromium, and Nickel are naturally found in the environment, but overexposure may be more common in certain workplaces and/or environments.
Outdoor air pollution
Family history of cancer
Having chronic lung diseases such as COPD (Chronic Obstructive Pulmonary Disease) and pulmonary fibrosis
E-cigarettes (vaping)
Chewing betel nut (more common amongst Asian immigrants)
Genetic mutations (changes in genes)

Genetic Mutations for Lung Cancer

Certain genetic mutations, also known as a “change in genes,” can increase your chance of getting cancer. It is important to know that genetic mutations can be inherited from your parents OR can develop after birth. Also, not all mutations are bad.

Unfortunately, in lung cancer, many people will not know they have a genetic mutation until they already have cancer, as these types of mutations can only be found in lung cancer cells.

Mutations common in lung cancer are EGFR, KRAS, BRAF, and less common mutations are MET, ALK, and ROS-1.

If you have lung cancer, it is important for your doctor to do genetic testing to see if your lung cancer has a mutation because:

Certain mutations in lung cancer, like EGFR, are more common in certain ethnic populations, such as Asians and some Hispanics.
There may be treatments that specifically fight these types of lung cancer with mutation.

If you have been diagnosed with lung cancer and are interested in learning more about genetic testing or mutations in lung cancer, contact a CHM Patient Navigator here.

Lung Cancer Screening Guidelines for Smokers and Ex-Smokers

U.S. guidelines recommend that people between 50 and 80 years old who smoke, or smoked in the past, on a regular basis (defined as 20 cigarettes per day for 20 years, 40 cigarettes per day for ten years, ten cigarettes per day for 40 years) get screened with a test called low dose CT scan (LDCT) every year. If you have health insurance, this test should be covered at no cost to you.

Unfortunately, these screening guidelines exclude never-smokers, including Asian American, African American, and some Hispanic communities, who have a higher proportion of never-smokers with lung cancer.

What Can Never-Smokers Do?

Currently, there is no test that can screen for lung cancer in never-smokers.

It is important to be aware of the risk factors for lung cancer, go to your doctor for annual checkups, tell your doctor if you have risks for lung cancer and if you experience symptoms of lung cancer, such as a long-standing cough that does not go away.

This is especially important for never-smoker populations who are at higher risk for lung cancer, such as Women, Asians, African Americans, and certain Hispanic American groups.

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