Commentary: More must be done to prevent lung cancer

By Dr. Albert Rizzo

As a resident of Delaware, a practicing pulmonologist and the chief medical officer of the American Lung Association, I see the impacts of lung cancer every day. Lung cancer is the nation’s leading cause of cancer deaths, and it’s estimated that 890 Delaware residents will be diagnosed with this disease in 2020 alone. The 2020 “State of Lung Cancer” report from the American Lung Association finds that while more Americans are surviving the disease, people of color are facing poorer health outcomes than White residents and that Delaware can do more to improve lung cancer new-incidence and surgical treatment rates.

Dr. Albert Rizzo

The third annual report, released Nov. 17, examines the toll of lung cancer throughout the nation and outlines steps every state can take to better protect its residents from lung cancer.

In Delaware, the lung cancer survival rate is average at 23.1%, ranking 17th out of the 47 states measured. Delaware’s new-case incidence rate is higher than the national average (67.4 per 100,000 people, compared to 58.7, respectively), ranking 39th nationally. Anyone can get lung cancer. While smoking is the No. 1 risk factor and is responsible for about 90% of lung cancer cases, a large number of cancer diagnoses are in never and former smokers. Current lung cancer incidence numbers may result from elevated smoking rates from decades ago; exposure to secondhand smoke; increased exposure to other causes of lung cancer, such as radon and air pollution; or other factors, including family history.

The stage at which someone is diagnosed with lung cancer varies significantly by state. Nationally, only 22.9% of cases are caught early, when the five-year survival rate is much higher (59%). In Delaware, the survival rate is 23.1%, and early diagnosis is among the best in the nation at 26% (fifth out of 49 states measured). Cases that are diagnosed at an earlier stage, before the tumor has spread, are also more likely to be eligible for surgery, though Delaware’s surgery rate as the first course of treatment is below the national average at 18.4%. More Americans than ever are surviving lung cancer. This trend is promising, yet the disease remains the No. 1 cause of cancer deaths in the nation.

More treatment options are available for lung cancer than ever before, yet not everyone is receiving treatment following diagnosis. In Delaware, 15.5% of those diagnosed did not receive any form of treatment. While not everyone may choose to pursue treatment after diagnosis, no one who wants treatment should be forced to go untreated due to cost or lack of accessibility.

Lung cancer screening can help detect the disease early, when it’s more curable. If everyone eligible were screened, close to 48,000 lives in the U.S. would be saved. While Delaware ranks above average compared to other states, only 8.6% of eligible Delaware residents were screened in 2019, indicating there is need for education and awareness.

Lung cancer screening is a powerful tool to save lives. It’s a relatively new test, and we’re only seeing a fraction of those who qualify actually getting screened. The American Lung Association is continuing to push for greater awareness of this test to save more lives here in Delaware and encourage former and current smokers to learn about screening and take the screening eligibility quiz at

Our state officials must do more to protect and expand quality and affordable health care coverage and improve access to lung cancer screening and treatment. The American Lung Association wants to ensure that all Delawareans have access to treatment options and quality and affordable health care.

Dr. Albert Rizzo is chief medical officer for the American Lung Association.