Lung Cancer Awareness Month (November) has passed, but it is still a good time to reflect upon the magnitude and impact of this disease. Lung cancer is the No. 1 cancer killer of men and women in the U.S., and its toll in Maine is tremendous. Our state has the sixth highest lung cancer incidence rate in the nation.
The Maine Lung Cancer Coalition ((http://mainelungcancercoalition.org/) is a multi-year project which seeks to raise awareness of lung cancer and to decrease the impact of the disease on Maine people. Its mission is simple — reduce the risks, detect cancer early and improve patient outcomes.
It is imperative that Mainers understand the factors that contribute to lung cancer in order to minimize their risk. While smoking remains the leading preventable cause of lung cancer — accounting for about 80 percent of cases — anyone can get lung cancer. Environmental factors, such as exposure to radon gas, second-hand smoke and air pollution, are also important risk factors.
The best way to lower the risk of lung cancer is to reduce tobacco use. Maine’s high-school smoking rate is 33 percent higher than the national average. The adult rate is 27 percent higher.
For years, Maine was a leader in tobacco prevention efforts, which resulted in a decline in smoking rates. However, state policymakers have diverted tobacco settlement funds away from prevention efforts to fill other budget holes. Not surprisingly, progress has stalled. Hardest hit by these policy changes, furthermore, are Mainers living in rural counties, who have disproportionately high rates of smoking and death from lung cancer — among the highest in the nation.
Fortunately, we know how to improve, since we have done it before.
Maine legislators must reverse the funding cut for the tobacco prevention program approved earlier this year and invest in proven methods that reduce smoking rates.
Tobacco tax increases remain the most effective policy tool to promote smoking cessation and prevent its initiation among youth. Maine last raised the tax in 2005, giving the state the highest tax in the Northeast. But Maine hasn’t kept pace, and now has the second lowest tax. We owe it to our kids to do all we can to make sure they never become addicted to nicotine, and to all smokers to help them quit.
Early detection of lung cancer is also important.
Too many people are unaware of a new, life-saving tool called low-dose CT (LDCT) — a special X-ray scan that can find lung cancer at an early stage when it is more treatable. LDCT screening is recommended for high-risk individuals — aged 55-80 with a heavy smoking history — who either currently smoke or have quit within the past 15 years.
Like all screening tests, LDCT isn’t perfect; it can cause false alarms, and not everyone benefits from it. But it can be life-saving, and eligible people should have the opportunity to decide whether it makes sense for them. Currently most private insurers and Medicare cover LDCT screening, however MaineCare does not. Maine legislators can correct that coverage gap by funding LD 720, which passed overwhelmingly in both chambers last session.
An estimated 9 million Americans are eligible for screening. Screening just half of them would save 15,000 lives. The Maine Lung Cancer Coalition is working to promote access to high-quality lung cancer screening in Maine. Entering our second year of work, we have successfully brought together health care providers from across the state to share best practices and make screening accessible to Mainers. People can visit the American Lung Association’s “Saved by the Scan” initiative at www.SavedByTheScan.org to learn more about screening.
Every 2½ minutes an individual in the U.S. is diagnosed with lung cancer. Nearly 1,400 Mainers will be diagnosed this year. But this terrible disease remains in the shadows and not adequately addressed by the health care system or research community.
We are working to reverse this situation, employing every strategy we know to prevent lung cancer, detect it early, and provide the highest quality treatment possible for those with the disease.
With help from lawmakers in Augusta to address the tobacco epidemic and gaps in coverage for lung cancer screening, we can make great strides in fighting this disease.
Paul Han, MD, MA, MPH, is principal investigator and co-lead of the Maine Lung Cancer Coalition, a statewide, multi-institution, multi-disciplinary initiative to improve the prevention, early detection and treatment of lung cancer in Maine.
Paul Han, MD, MA, MPH