Hawaii once again ranks last in the nation for early­-stage diagnosis for lung cancer, according to a recently released report from the American Lung Association.

In addition, Hawaii ranks near the bottom for screening and survival rates from lung cancer, and below average for surgical treatment. This ranking for early diagnosis and surgical treatment has not changed for the past five years, according to the 2022 “State of Lung Cancer” report, released last week.

The fifth annual report examines the toll of lung cancer in Hawaii via key indicators such as new cases, survival, early diagnosis, surgical treatment, lack of treatment and screening rates.

“Lung cancer screening is key to early diagnosis, and early diagnosis saves lives,” said Pedro Haro, executive director of the American Lung Association in Hawaii, in a statement. “Unfortunately, here in Hawaii, not enough people are getting this lifesaving screening. We all can help reduce the burden of lung cancer in Hawaii. If you are eligible for lung cancer screening, we encourage you to speak with your doctor about it. If a loved one is eligible, please encourage them to get screened.”

In Hawaii, only about 20% of cases are caught at an early stage, significantly lower than the national rate of 26%.

The bright side is that the rate of new lung cancer cases in Hawaii is significantly lower than the national rate, which has also not changed significantly in the past five years.

Lung cancer, however, remains the leading cause of cancer deaths in Hawaii and the U.S.

Nationally, there has been some improvement, with the five-year survival rate in the U.S. now at 25% — a 21% increase from 2014 to 2018. In Hawaii, however, the lung cancer survival rate is below the national average at 21.7%, which advocates said could improve if there were higher early detection rates.

“Obviously, catching it early is essential to being able to have better treatment options and better outcomes,” Haro said.

An estimated 890 Hawaii residents will be diagnosed with lung cancer this year, according to ALA, and 540 will die from the disease. Native Hawaiians are more likely to be diagnosed with lung cancer than any other groups in Hawaii.

Very few residents at high risk who are eligible for an annual low-dose CT scan, which can detect tumors at early stages, actually get it, said Haro.

This could be due to lack of awareness, given that nearly 70% were not familiar with the availability of screening for early detection, according to ALA’s 2022 Lung Health Barometer.

Haro said the state Legislature has appropriated $250,000 for the establishment of a task force to draw up a strategic plan on how Hawaii can improve its early screening for lung cancer, and he eagerly awaits their findings.

ALA Hawaii will continue to push for legislation that prevents people from starting any form of tobacco use, whether it be smoking or vaping, or to quit, to prevent lung cancer in the first place, he said.

Guidelines for screenings expanded in March, and now include people 50 to 80 years old who have a 20 pack-year smoking history (1 pack a day for 20 years or 2 packs a day for 10 years) and currently smoke or have quit within the past 15 years.

This nearly doubled the number of people eligible for screening, ALA said, and has the potential to save significantly more lives. More information on eligibility is available at SavedByTheScan.org.

‘STATE OF LUNG CANCER’ IN HAWAII REPORT 2022

Hawaii ranks:

Above average

>> 6th in the U.S. for rate of new lung cancer cases at about 44 per 100,000, compared with 57 per 100,000 nationally.

Below average

>> 34th in the nation for surgery at about 18%, compared with 21% nationally. Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread.

>> 39th in the U.S. for five-year survival rate after a lung cancer diagnosis, at about 22%, compared with 25% nationally.

Bottom

>> 43rd in the U.S. for lung cancer screening at about 3%, compared with about 6% nationally. Lung cancer screening with annual low-dose CT scans for those at high risk can reduce the lung cancer death rate by up to 20%.

>> 44th in the nation for lack of treatment, with 25% of cases not receiving any, compared with 21% nationally.

>> 49th in the nation for early diagnosis of cases at about 20%, compared with 26% nationally.

Source: American Lung Association