I have spent my career focused on the intersection between cancer research and public health. Since joining LUNGevity over a decade ago, it has been nothing short of a privilege to witness how research has changed how we diagnose and treat lung cancer. We have seen unimaginable improvements in the field. However, this scientific progress seems to have outpaced our ability to effectively deliver these benefits to all patients.
Key questions remain:
- Is every person at an increased risk of developing lung cancer getting screened?
- Is every person diagnosed with lung cancer receiving the best treatment possible?
A new report from the American Association for Cancer Research (AACR Cancer Disparities Progress Report 2026) lays out both the progress in lung cancer treatments and the remaining challenges for the lung cancer community.
We Have Successfully Built a New Era of Lung Cancer Treatment
Lung cancer death rates have been declining, and that decline has accelerated over the past decade.
Consider the timeline. In 2003, the first targeted lung cancer therapy was approved. Since then, researchers have identified key molecular changes, in genes like EGFR, ALK, ROS1, and many more, that drive lung cancer growth. These findings have allowed us to build precision medicines and immunotherapies aimed directly at the genetic drivers of lung cancer.
We are thrilled to hit treatment milestones nearly every year that offer new and improved ways to target disease and overcome drug resistance.
This isn't just abstract science. It’s the reason people are routinely doing something that seemed impossible a decade ago: living longer, fuller lives with lung cancer.
This progress is tangible in the patients we talk to. They are focused on living their best lives. This Increased survival is clearly represented in the data too. Five-year survival for lung cancer has more than doubled since the 1970s—jumping from 12% to 28% in the 2020s.
We have also seen survival shifts within different populations. Lung cancer mortality among Black individuals was 23% higher than White individuals in 1991. By 2024, it was actually 4% lower, one of the clearest examples of an equity gap that closed.
A Bitter Pill to Swallow: Not Everyone Benefits Equally
Here's what stayed with me after reading the report from AACR. We have celebrated major scientific breakthroughs to advance treatment options for lung cancer, but we have also left a lot of potential benefits on the table.
Missed opportunities in screening and treatment
Lung cancer screening, a simple low-dose CT scan, can catch cancer before symptoms appear, when it's most treatable. Yet only about 19% of eligible people actually get screened, the lowest uptake of any recommended cancer screening—far behind breast (80%), colorectal (75%), cervical (73%), and prostate (37%) screening. If everyone eligible were screened, researchers estimate we could prevent 62,110 lung cancer deaths over five years. That’s four times what current lung cancer screening rates achieve!
Also, screening eligibility rules don't fit the needs of different groups. For example, current guidelines lean heavily on tobacco exposure history, but Black individuals often develop lung cancer at lower levels of tobacco exposure than White individuals.
This means many people who need screening don’t meet the current eligibility criteria. The data shows only 47% of Black patients aged 50–54 who were diagnosed with lung cancer would have been eligible for screening, versus 80 percent of White patients in the same age group.
Biomarker testing identifies which targeted therapy might work best for a specific tumor. But in real-world studies, only 18%-39% of advanced lung cancer patients received it. Patients without a college education were about 70% less likely to be tested than those with a college degree.
Your ‘z-code’ matters as much as your genetic code
Several years ago, Robert Winn, MD, director of Fox Chase Cancer Center and member of LUNGevity’s board of directors, introduced me to the concept of ‘z-code’—the idea that where you live (i.e. your zip code) matters.
Rural communities face lung cancer incidence rates that are 37% higher than urban areas, and death rates are now 47%-55% higher. This is a stark reversal from the 1970s, when lung cancer mortality was actually lower in rural communities.
Chronic stress leaves a biological mark
The concept of “allostatic load”, something that public health practitioners have long known about, is new to oncology. Recently, researchers measured allostatic load—the cumulative wear and tear that chronic stress, discrimination, and hardship place on the body—and found that people with high allostatic load had a 15% increased risk of developing lung cancer. This is a reminder to all of us that cancer risk isn't only about individual choices. It is very much shaped by the environments and situations people live in.
And of course, trust matters too
Medical mistrust, often rooted in real historical harms, makes some people less likely to seek the care they need and deserve. For example, people who don’t trust the medical systems often won’t participate in lung cancer screening even if they qualify. Rebuilding that trust certainly takes effort, but it also works. A program built with Black churches, using trusted messengers and tailored outreach, measurably improved awareness of and engagement with lung cancer screening.
Why This Matters For the Lung Cancer Community
Each of these gaps is something research and smart policy can fix, and we have already seen the benefits take hold. Patients who received one-on-one navigation support were nearly five times more likely to complete lung cancer screening within six months than those who received usual care. And when Black patients treated with immunotherapy were followed in a large Veterans health study, their outcomes were just as good, sometimes slightly better, than White patients, with less treatment-related toxicity. These are clear proof points that equitable access can translate directly into equitable patient outcomes.
This is also where research funding makes the difference. We are leveraging the brilliant science that gave us EGFR-targeted therapies and immunotherapy to also support health care equity so that we can understand why lung cancer behaves differently across populations and make sure every patient, regardless of zip code, income, or insurance status, benefits from the progress science has already given us.
We have made remarkable progress against lung cancer—and we will continue to do more. But we also need to make sure this progress belongs to everyone.