Lung cancer kills more Americans than any other form of cancer: more than prostate cancer and colon cancer combined, and nearly three times as many as breast cancer. But while pink ribbons are a familiar sight and 4 in 5 women get their recommended mammograms, screening for lung cancer is far less common. It’s often viewed as a disease primarily of heavy smokers, when the reality is far more nuanced.
Technology offers new opportunities to catch lung cancer early, when it can be treated most easily. But official screening guidelines, which play a major role in determining whether insurance will cover the cost of screening, often fail to pinpoint who is at risk. What’s more, only 20% of people who are eligible for screening actually get checked. Some of this failure can be traced to persistent myths about lung cancer.
Filling the void for cancer care in rural Colorado
Myth: Lung cancer is only a disease of smokers
Juliet DuBois learned that she had cancer after she had a hip replacement two years ago, at age 46. In the weeks after the operation, a blood test showed warning signs of a possible blood clot. DuBois went to the ER, where a CT scan revealed a 1-centimeter mass in her lung.
After four rounds of chemo, she now says she’s feeling “pretty good” and has no evidence of disease. This winter, she started an online MBA program, chasing a dream she put off for years. “It can’t be as scary as cancer,” DuBois said.
Both of DuBois’ parents were heavy smokers, which turned her off cigarettes and kept her from ever picking up the habit. Lung cancer screening was never on her radar: “I just wonder, if someone had recommended it, if I’d have done the thing.”
In fact, as many as a quarter of all lung cancer appears in “never-smokers,” defined as smoking fewer than 100 cigarettes in a lifetime. Lung cancer in nonsmokers is more common among women than men, and it’s especially common in women with East Asian or South Asian ancestry. One study found that 83% of female lung cancer patients in south Asia were never-smokers.
Myth: Only heavy smokers need worry
Albertha “Bertie” Gethers started smoking in junior high, hanging out with friends in Mattapan, Massachusetts. It was the 1960s, and for 12-year-old Bertie, Virginia Slims were the brand. “We thought it was cute,” she recalled.
Gethers never smoked more than a few cigarettes a day, even as she kept up the habit for another 56 years. Because it didn’t add up to a “20-pack-year” smoking history – the equivalent of a pack a day for 20 years – she didn’t meet official criteria for screening. That meant Medicare wouldn’t pay for it, and no doctor suggested that she seek out screening on her own.