"Advancing Health Equity Across the Lung Cancer Continuum: Where we are now and future directions"
Lung cancer is the leading cause of cancer-related death in the United States (U.S.), killing more patients than breast, prostate, colon, and pancreatic cancers combined. Lung cancer incidence and mortality are highest in Black men compared to all other racial and ethnic groups. Despite similar smoking rates, Black men on average are diagnosed at earlier age and later stage, with lower likelihood of surgical or any treatment than White Americans. Similarly, Latino Americans, Asian Americans, and American Indians and Alaska Natives are less likely to be diagnosed early and more likely to receive no treatment than White Americans. Although early detection with low-dose computed tomography (LDCT) lung cancer screening can reduced lung cancer-specific mortality by 20-24% in high-risk adults, LCS uptake among eligible adults is unacceptably low (~6%) due to substantial barriers at the patient, provider, and health system levels, which are magnified in racial and ethnic minoritized and low-socioeconomic status populations and compounded by additional barriers, such as language and communication issues, un/underinsurance, discrimination and bias, and lower eligibility. Understanding and mitigating social and behavioral drivers of risk and barriers to early detection are critical to achieving health equity across the lung cancer continuum. This lecture will explore 1) the state of lung cancer and screening; 2) relationships between lung cancer and social and behavioral health determinants; 3) barriers to screening and strategies to overcoming barriers; and 4) future directions towards lung health equity.