Written by Karissa Hanson, NP | Western Wisconsin Health – Spring Valley Clinic

Lung cancer affects every community, including our own, but especially in rural communities given the significant disparities in healthcare access, resources, higher smoking rates, or socioeconomic challenges. Whether it’s someone you love, a neighbor, or a coworker, many people are impacted by lung cancer. At Western Wisconsin Health (WWH) we encourage you to have annual visits with your primary care provider to discuss individual risks and testing.

Lung cancer remains the leading cause of cancer-related deaths worldwide, accounting for nearly 1.8 million deaths annually (World Health Organization [WHO], 2021). Despite advances in treatment, the overall five-year survival rate for lung cancer is approximately 18.6%, largely due to late-stage diagnosis (American Cancer Society [ACS], 2023). Early detection through lung cancer screening offers a promising strategy to reduce mortality by identifying the disease at an earlier, treatable stage.

Lung cancer develops when abnormal cells grow uncontrollably in the lungs, often forming tumors. Most patients with lung cancer are diagnosed at an advanced stage when symptoms—such as persistent cough, chest pain, or coughing up blood—become apparent. Unfortunately, at this stage, curative treatment is less likely.

Smoking is the leading risk factor, responsible for approximately 85% of lung cancer cases. Other contributors include secondhand smoke exposure, radon gas, occupational exposure to carcinogens (e.g., asbestos), and genetic susceptibility (U.S. Preventive Services Task Force [USPSTF], 2021).

Cancer screening involves testing asymptomatic individuals to detect diseases early. For lung cancer, the most effective screening tool is low dose computed tomography (LDCT). This imaging method uses significantly less radiation than standard CT scans while effectively detecting small lung nodules that may indicate cancer. The National Lung Screening Trial (NLST), a landmark study published in 2011, demonstrated that LDCT screening reduced lung cancer mortality rates by 20% compared to chest X-ray in high-risk populations (National Cancer Institute, 2011).

The U.S. Preventive Services Task Force (USPSTF) updated its recommendations in 2021, advising yearly LDCT screening for adults who: Are aged 50 to 80 years, have a 20 pack-year or more smoking history, and currently smoke or have quit within the past 15 years. The American Cancer Society updated its guidelines in 2023, aligning with USPSTF criteria and emphasizing the importance of shared decision-making and access to high-quality screening programs (ACS, 2023). If you or a loved one meets these criteria, please call WWH at 715-684-1111 to schedule an appointment.

The benefits of screening with an LDCT are that it can detect lung cancers at stage I or II, when they are more likely to be curable. Studies have shown that early-stage lung cancers identified through screening have a five-year survival rate of over 60%, compared to less than 10% for late-stage diagnosis (NCI, 2023).

Living in a rural area can have its limitations with access and equity issues. Lung cancer screening is often underutilized, particularly in underserved communities. Barriers include lack of awareness, limited access to LDCT facilities, transportation challenges, financial insecurities, and healthcare disparities. Addressing these challenges is essential to ensure that the benefits of screening reach all eligible populations.

At WWH, we are committed to improving lung cancer screening by focusing on public education, raising awareness about eligibility and benefits of screening, and reducing the stigma around smoking and lung cancer. We are committed to narrowing the gap for survival rates.

References

• American Cancer Society. (2023). Lung cancer screening guidelines. https://www.cancer.org
• National Cancer Institute. (2011). National Lung Screening Trial (NLST) results. https://www.cancer.gov
• National Cancer Institute. (2023). Lung cancer treatment (PDQ®)–Health professional version. https://www.cancer.gov
• U.S. Preventive Services Task Force. (2021). Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(10), 962–970. https://doi.org/10.1001/jama.2021.1117
• World Health Organization. (2021). Cancer fact sheet. https://www.who.int/news-room/fact-sheets/detail/cancer