In November, the American Lung Association released its 2024 "State of Lung Cancer" report, which examines key indicators to highlight how the toll of lung cancer varies by state. Lung cancer is the leading cause of cancer deaths in Alabama and across the U.S. The report finds that the survival rate in Alabama is the second worst in the country, at 22.3%, compared to the national average of 28.4%.

The Lung Association's seventh annual "State of Lung Cancer" ranks Alabama:

• 35 out of 49 in the nation for rate of new lung cancer cases at 58.7 per 100,000. The national rate is 53.6 per 100,000.
• 46 out of 47 in the nation for survival at 22.3%. The national rate of people alive five years after a lung cancer diagnosis is 28.4%.
• 40 out of 47 in the nation for early diagnosis at 25.3%. Nationally, only 27.4% of cases are diagnosed at an early stage when the survival rate is much higher.
• 10 out of 51 in the nation for lung cancer screening at 19.4%. 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%. Nationally, only 16% of those at high risk were screened.
• 41 out of 47 in the nation for surgery at 15.4%. Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread. Nationally, 20.7% of cases underwent surgery.
• 37 out of 47 in the nation for lack of treatment at 23.3%. Nationally, 20.9% of cases receive no treatment.
• 41 out of 51 in the nation for smoking at 15.6%. Nationally, 11.6% of adults currently smoke.

The report also reveals health disparities, with Black individuals in Alabama least likely to receive surgical treatment.

Overall, the "State of Lung Cancer" report reveals positive news. Nationally, the lung cancer survival rate has improved 26% in the last five years due to increased awareness and advancements in detection and treatment.

The report also presents opportunities for Alabama to further improve lung cancer survival by increasing access to lung cancer screening, which can detect the disease at an earlier stage when its more curable, and biomarker testing, which can help influence treatment options because not all lung cancers are the same.

"Lung cancer is a devastating disease and impacts far too many families in Alabama. To address the burden of lung cancer and to help improve the lives of people it impacts, we must continue to evaluate the greatest needs. This report helps us prioritize which areas to focus on to truly make an impact," said Ashley Lyerly, senior director of advocacy for the American Lung Association. "This year's 'State of Lung Cancer' report shows that Alabama must focus on increasing access to lung cancer screening, smoking cessation programming and biomarker testing to save lives. Together, we can make a difference."

New this year, "State of Lung Cancer" examines health insurance coverage requirements of comprehensive biomarker testing across the U.S. Lung cancer biomarker testing sometimes referred to as tumor, molecular, genomic or genetic testing, looks for changes in the tumor's DNA. The results of the test may show biomarkers that can help determine what treatment options would be best for an individual patient. Insurance coverage of biomarker testing is important for removing a cost barrier to people with lung cancer, but coverage for biomarker testing is only required in some states. Alabama does not require insurance coverage of comprehensive biomarker testing.

The 2024 "State of Lung Cancer" report highlights opportunities for states and the federal government to reduce the burden of lung cancer and encourages everyone to help end lung cancer. This year, the American Lung Association calls for the state to implement policies to require Insurance coverage of comprehensive biomarker testing. The Lung Association also calls on Congress to pass the Increasing Access to Lung Cancer Screening Act (H.R. 4286).

Alabama is the only state that does not provide annual low-dose CT scans for lung cancer screening as a covered service for all individuals at high risk without any administrative or financial barriers within the Medicaid program. Lung cancer screening with low-dose CT scans has been shown to save lives, reducing the lung cancer death rate by up to 20%. Early detection and treatment of lung cancer translates into higher survival rates. The Alabama Medicaid Agency should not only cover lung cancer screening for those at high risk but also provide healthcare access for those in the coverage gap through Medicaid Expansion.