Lung cancer is the leading cause of cancer death in Hawaii, affecting nearly 900 people last year and killing 540.

This disease is deadly because symptoms don’t appear until later stages when the cancer has already spread around the body and is much harder to treat. People often don’t get diagnosed early enough.

Lung cancer screening is a quick way of ensuring you don’t overlook something important. It involves computed tomography (CT) chest scans to search for lung nodules, and doesn’t require medications, food restrictions or needles.

If these screenings are painless and crucial, why did Hawaii place last in the nation for early-stage lung cancer diagnosis, screening at half the rate of the national average for two years in a row?

To date, only one research study has investigated statewide lung cancer screening completion rates among Native Hawaiian and Pacific Islanders, who experience disproportionately high lung cancer deaths. An early lung cancer screening task force commissioned by the Hawaii Legislature in 2022 is in the process of uncovering more answers. In the meantime, research suggests people often do not get screened because they fear discovering their cancer, aren’t aware that screenings exist, or have cost and safety concerns.

Lung cancer CT screenings have been around since the late 1900s and are offered by health centers here, which can be found using the American College of Radiology’s online “Lung Cancer Screening Locator Tool.” November, lung cancer awareness month, is a helpful reminder to schedule your annual appointment.

Lung cancer screening is appropriate for those meeting high-risk criteria: people ages 55 to 80, have smoked within the past 15 years, or have a 20-plus-pack-a-year smoking history. The American Lung Association’s online “Lung Cancer Risk Quiz” can help determine your screening eligibility.

Lung cancer doesn’t just concern those with a smoking history. The risk of developing lung cancer is linked to second-hand smoking, radon gas exposure in enclosed underground spaces like basements, and air pollution near heavily trafficked roads. Though evidence is still being studied, the American Cancer Society cautions against marijuana and e-cigarette usage — habits popular among youth — because the smoke contains carcinogenic tar and tobacco-derived nicotine, respectively.

Smoking these substances can also lead to lung diseases like chronic obstructive pulmonary disease and emphysema, which can coincide with and worsen lung cancer symptoms and survival outcomes.

Tests typically cost around $700 out of pocket, but insurance providers may cover around 80% to 90% of the cost with pre-approval if in a high-risk group. Since 2022, Medicare has covered annual lung cancer screenings for those who qualify. Additionally, organizations like Hawaii Pacific Health cover 40% of the cost for those who are uninsured.

Regarding safety, lung cancer CT screenings are conducted with a radiation dose a fifth that of regular CTs, and as low as half of the naturally occurring radiation an average person is exposed to each year.

Potentially uncovering upsetting news by getting screened may provoke anxiety, but doing so presents a chance to act early and prevent the worst.

With COVID, we all learned the importance of lung health. We’ve witnessed loved ones suffer on ventilators. Our entire lives have been halted. As researchers predict an increase in lung cancer deaths to 3 million globally by 2035, it is critical to ask ourselves what we can do on both individual and aggregate levels. How can we change these statistics?

What you can do is what our state has been struggling with: spreading awareness about lung cancer screenings, supporting cancer research studies, and practicing healthy living. Empower each other to act together. Take a deep breath, then take your next step.

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Kasen Wong, an alumnus of the Center for Tomorrow’s Leaders, is a 2023 graduate of the University of Southern California and incoming student at the John A. Burns School of Medicine, University of Hawaii.

“Raise Your Hand,” a monthly column featuring Hawaii’s youth and their perspectives, appears in the Insight section on the first Sunday of each month. It is facilitated by the Center for Tomorrow’s Leaders.

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CTLhawaii.org