Doctors treat a patient in a hospital emergency room. Getty Images.
Pamela Trombero, 68, said it was a like a “slap in the face” when she received the news in 2006 that she was diagnosed with Stage 1 lung cancer.
After her diagnosis, Trombero stopped smoking and went through six months of chemotherapy and surgery. Now, 18 years in remission, she leads a virtual cessation program to help others quit smoking and encourages her friends and family members to regularly get screened for lung cancer.
“People need to do that,” she said “People should not be afraid of it, because it’s better to prevent anything from happening.”
The American Lung Association agrees with her. According to the “State of Lung Cancer” report released Tuesday, screenings are one of the best tools to catch lung cancer early.
“We know that not enough people are getting screened, and I think Maryland falls right in line with that,” said Aleks Casper, the association’s director of advocacy for Maryland, Delaware, Virginia and Washington, D.C. “If we can get somebody screened, we can get them an early diagnosis and you can get them access to treatment.”
Screening and early diagnosis were the two areas where Maryland was weakest compared to other states, according to the report, which looked at data from 2021, the most recent year for which numbers were available. The report said Maryland was 23rd of 51 states and the District for screening, and 26th of 47 states for early diagnosis.
In other areas, Maryland did relatively well. It was 16th for the rate of new cancer cases, at 50.2 per 100,000 residents, compared to a national rate of 53.6 per 100,000. It was 13th of 47 states for the lung cancer survival rate, at 30.1% compared 28.4% nationally.
Maryland did best when it comes to the number of smokers: The 9.6% of adults in the state who smoke was second only Utah. Nationally, 12.8% of adults smoked in 2022, the most recent year for which that data is available.
Overall, trends improved over the five-year period from 2017 to 2021 that the report looked at. Nationally, survival rates went up and the number of new cases went down, the report said. But close to 235,000 people will be diagnosed with lung cancer this year nationwide, according to the report, and 361 on average will die from lung cancer per day.
Dr. Panagis Galiatsatos, a spokesperson for the American Lung Association National and an assistant professor for Johns Hopkins School of Medicine, says that “more needs to be done.”
“I think we are doing fine, but there’s still plenty of room for improvement,” he said.
The people most at risk for lung cancer are those aged 50 to 80 years old who have a history of smoking or are current smokers. People who fit this category are urged to get annual lung cancer screenings.
“Screening with annual low-dose CT scans can reduce the lung cancer death rate by up to 20% by detecting tumors at early stages when the cancer is more likely to be curable,” the 2024 report says.
Another way to improve the state of lung cancer is to reduce smoking. While Maryland does well as a state in that area, the rate of smoking varies by location within the state, Galiatsatos said.
“In your rural areas and in your urban areas, you still see high rates of smoking occurring, so the state as a whole hasn’t seen a uniform drop,” he said. “It’s rather disproportionate and really falls along the lines of rural status and socio-disadvantaged neighborhoods in cities like Baltimore.”
The 2024 report also looked at which states currently insurance to cover what’s called biomarker tracking, a wide range of tests where blood, tissue or other samples are collected throughout cancer treatment to see if the selected treatment has been effective.
Maryland passed a law in 2023 requiring that insurers cover biomarker testing, one of 15 states that does so. The law went into effect for private insurers in January, and will go into effect for Medicaid enrollees starting July 2025, so long as there is money in the state budget.
Casper hopes that the biomarker law in Maryland will help improve treatment and survival rates for lung cancer patients.
“Biomarker testing is a huge opportunity … that helps determine what treatment will be the best for individuals.” Casper said. “That’s something that we’re really highlighting, that Maryland has really made steps to ensure that people who are living with a lung cancer diagnosis have access to the best treatment available and individualized treatment available through biomarker testing.”
But there is not one solution, she said. Reducing the toll of lung cancer in the state will require a multifaceted approach and that advocates, doctors and policymakers need to “continue focusing on what we can do to make people healthy.”
“We can prevent people from starting to smoke anything … and then ensuring that people have the resources to make them successful when they want to make that quit attempt,” she said. “And then the follow-up piece ensuring that we are talking about messaging, both as a consumer … but also to a provider to be talking to their patients about eligibility and talking about how to receive lung cancer screening.”