Lung cancer is the most commonly diagnosed cancer worldwide,1 and the leading cause of cancer deaths in the United States.2 In fact, more Americans die from lung cancer each year than breast, colon and prostate cancer combined.2 But there is hope for people diagnosed with lung cancer. Through scientific research and developments, we are making significant progress in understanding and treating the disease.

Yet, surprisingly, a growing number of studies show that many people with advanced lung cancer never receive cancer care, far more than for any other type of cancer.

  • 1.Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.1, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2014. http://globocan.iarc.fr. Accessed August 27, 2015.
  • 2.American Cancer Society. Cancer Facts & Figures 2015. Atlanta: American Cancer Society; 2015.
  • 3.SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer. National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/statfacts/html/lungb.html.
  • 4.Small AC, Tsao C-K, Moshier EL, et al. Prevalence and Characteristics of Patients with Stage IV Solid Tumors Who Receive No Anticancer Therapy. Poster presented at The American Society of Clinical Oncology Annual Meeting on June 4, 2012.

Emerging research suggests that specific perceptions of lung cancer such as stigma, blame and hopelessness may be a factor in lack of treatment.1 The Lung Cancer Project has conducted research to better understand the social psychology of lung cancer in order to change the way people think about the disease.

Since the 1950's, society's attitudes and the understanding of lung cancer have played a role in shaping perceptions of people with the disease. To understand where we are today, we need to first take a look back.

Does a negative bias towards people with lung cancer really exist? Yes. Does a negative bias towards people with lung cancer really exist? Yes.

We conducted a study of more than 3,000 people to understand the social psychology of lung cancer relative to breast cancer. For the first time, the study confirmed that people have a significantly negative bias and associate blame and hopelessness with lung cancer compared to breast cancer.2

Do you have a subconscious bias against lung cancer?

Do you have a subconscious bias against lung cancer? Find out by taking a sample of the Implicit Association Test (IAT) from our study. An IAT is a research tool designed to measure perceptions, stereotypes and other hidden biases that may influence judgment and action related to lung cancer.

The IAT was developed by researchers from The Lung Cancer Project in partnership with Project Implicit®, a team of scientists from Harvard University, the University of Virginia and the University of Washington, and with oversight from an Institutional Review Board (IRB). This research tool was introduced into scientific literature in 1998 and has since been widely used in the field of social psychology.

Begin the Test
Do you have a subconscious bias against lung cancer?
We learned from the initial study that healthcare professionals are equally biased towards people with lung cancer. Does that factor in to how they approach care? We learned from the initial study that healthcare professionals are equally biased towards people with lung cancer. Does that factor in to how they approach care?

Results from a study published in the Journal of Thoracic Oncology found that primary care physicians were less likely to refer people with advanced lung cancer than people with advanced breast cancer to a cancer specialist. In fact, people with breast cancer were more likely to be referred for further therapy, whereas people with lung cancer were often referred only for symptom control.6

Doctors who specialize in lung health, called pulmonologists, often diagnose lung cancer. Do they refer people with lung cancer to cancer specialists? And if so, does it happen quickly?

We collaborated with the International Association for the Study of Lung Cancer (IASLC) to conduct two studies to answer these questions.

  • 1.LoConte NK, Else-Quest NM, Eickhoff J, Hyde J, Schiller JH. Assessment of Guilt and Shame in Patients With Non-Small-Cell Lung Cancer Compared With Patients With Breast and Prostate Cancer. Clinical Lung Cancer. 2008;9(3):171-8.
  • 2.Schiller JH, Bowden CJ, Mills J, et al. Explicit and implicit attitudes toward lung cancer (LC) relative to breast cancer (BC). Program and abstracts of the 2013 Annual Meeting of the American Society of Clinical Oncology; May 31-June 4, 2013; Chicago, Illinois. Abstract 8017.
  • 3.Schiller JH, Bowden CJ, Mills J, et al. Explicit and implicit associations toward lung cancer (LC) relative to breast cancer (BC). Poster presentation at the 2013 World Conference on Lung Cancer on October 30.
  • 4.Mlodinow, L. (2012). Subliminal: How Your Unconscious Mind Rules Your Behavior. New York, NY: Pantheon Books.
  • 5.Tsung-wei M, Schiller JH, Tian J, et al. The predictors and effects of explicit and implicit attitudes against lung cancer (LC). Oral presentation at the 2015 World Conference on Lung Cancer on September 7.
  • 6.Differences in primary care clinicians’ approach to non-small cell lung cancer patients compared with breast cancer. J Thorac Oncol. 2007;2(8):722–728.59.
  • 7.Ganti AK, Hirsch FR, Wynes MW, et al. Access to Cancer Directed Therapies and Cancer Specialists in Patients with Metastatic Lung Cancer. Oral presentation at the 2015 World Conference on Lung Cancer on September 8.
  • 8.Ganti AK, Borghaei H, Hirsch FR, et al. Real-World Patterns of Access to Cancer Specialist Care among Patients with Lung Cancer in the United States: A Claims Database Analysis. Oral presentation at the 2015 World Conference on Lung Cancer on September 7.
Should people with lung cancer be hopeful? We think so. Should people with lung cancer be hopeful? We think so.

Scientists have made significant advancements in our understanding of lung cancer. For example, we now know that lung cancer is not one disease, but many. Different types of lung cancer are defined by the type of lung cell from which the cancer originates or by the genetics of the cancer, often referred to as biomarkers.1

Lung Cancer Biomarkers Today

As a result of the explosion of biomarker diversity, we have an unprecedented understanding of the many types of lung cancer. Today, more than half of lung cancers - representing more than 1 million people - are covered by known genetic biomarkers.

In addition, many people have lung cancer with known protein markers, such as PD-L1.

Learn More

5,6,7,8 *Pie chart data are for adenocarcinoma only.

As a result of the explosion of biomarker diversity, we have an unprecedented understanding of the many types of lung cancer. Today, more than half of lung cancers - representing more than 1 million people - are covered by known biomarkers.

In addition, many people have lung cancer with known protein markers, such as PD-L1.

Learn More

Pie chart data are for previously treated NSCLC only.
Through this better understanding of the disease, we've made great strides in diagnosis and treatment of lung cancer. Through this better understanding of the disease, we've made great strides in diagnosis and treatment of lung cancer.

Evolution of Lung Cancer Diagnosis

The techniques that pathologists use to diagnose lung cancer and help oncologists determine treatment have changed as we have learned more about the underlying biology of the disease.

Past

For many years, the only distinction doctors could make was whether a person had small cell or non-small cell lung cancer based on the size of cells in a tumor sample viewed under a microscope.

Present

Now, lab techniques called immunohistochemistry and fluorescence in situ hybridization are used to find specific genetic or protein biomarkers in a tumor sample to determine if a targeted treatment is appropriate.

Future

In the future, less-invasive diagnostics using blood plasma or saliva could help overcome the challenge of having limited tumor tissue to test as more personalized treatment options become available.

More needs to be done to substantially improve survival, from diagnosing lung cancer earlier to testing new medicines and combinations of medicines, and delivering the right treatment to the right person at the right time. We're heading in the right direction. Medicare will now cover routine lung cancer screening for people at high risk, and funding for research is on the rise.14 Now is the time.

  • 1.American Cancer Society. Lung Cancer (Non-Small Cell) Detailed Guide. http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.pdf.
  • 2.Subramanian J, Govindan R. Lung Cancer in Never Smokers: A Review. Journal of Clinical Oncology. 2007;25:561-570.
  • 3.National Cancer Institute. SEER Stat Fact Sheets: Lung and Bronchus Cancer. http://seer.cancer.gov/statfacts/html/lungb.html.
  • 4.American Cancer Society. Cancer Facts & Figures 2015. Atlanta: American Cancer Society; 2015.
  • 5.Kris MG, et al. JAMA. 2014; 311(19):1998-2006.
  • 6.The Clinical Lung Cancer Genome Project and Network Genomic Medicine. Sci Transl Med. 2013; 5(209):209ra153.
  • 7.GLOBOCAN. Lung Cancer Fact Sheet. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
  • 8.Vansteenkiste J et al. Atezolizumab monotherapy vs docetaxel in 2L/3L non-small cell lung cancer: Primary analysis for efficacy, safety and predictive biomarkers from a randomized Phase II study (POPLAR). Oral presentation at the 2015 European Cancer Congress on September 27.
  • 9.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology for Non-Small Cell Lung Cancer. http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
  • 10.Keedy V, Termin S, Somerfield M, et al. American Society of Clinical Oncology Provisional Clinical Opinion: Epidermal Growth Factor Receptor (EGFR) Mutation Testing for Patients With Advanced Non– Small Cell Lung Cancer Considering First-Line EGFR Tyrosine Kinase Inhibitor Therapy. Journal of Clinical Oncology. 2011;29(15):2121-2127.
  • 11.Pao W, Miller VA. Epidermal growth factor receptor mutations, small-molecule kinase inhibitors, and non-small-cell lung cancer: current knowledge and future directions. Journal of Clinical Oncology. 2005;23(11):2556-68.
  • 12.Cancer.net. Epidermal Growth Factor Receptor (EGFR) Testing for Advanced Non-Small Cell Lung Cancer. http://www.cancer.net/research-and-advocacy/asco-care-and-treatment-recommendations-patients/epidermal-growth-factor-receptor-egfr-testing-advanced-non-small-cell-lung-cancer.
  • 13.Garber K. ALK, Lung Cancer, and Personalized Therapy: Portent of the Future? Journal of the National Cancer Institute. 2010;102:672-675.
  • 14.National Institutes of Health. Estimates of Funding for Various Research, Condition, and Disease Categories 2011-2016. http://report.nih.gov/categorical_spending.aspx.

We all have a role in improving the lives of people with cancer. Whether it's understanding the barriers to care, addressing the stigma, or participating in clinical trials to help bring new medicines to people, together we can help everyone get the care they deserve.

The Lung Cancer Project, LUNGevity and the lung cancer community have teamed up to spark conversation and spread hope for people living with lung cancer. Get involved and tell the world what YOU think #EveryLungDeserves.

Share the facts to help raise awareness, join the conversation and be proactive about care for yourself or your loved one.

  • 1.Lung Cancer Alliance. Congress Brings Heightened Focus On Lung Cancer. http://www.prnewswire.com/news-releases/congress-brings-heightened-focus-on-lung-cancer-300134400.html.
  • 2.Roth JA, Goulart BHL, Ravelo A, et al. Survival Gains from Systemic Therapy in Advanced Non-Small Cell Lung Cancer in the U.S., 1990-2015: Progress and Opportunities. Poster presentation at the 2015 World Conference on Lung Cancer on September 7.
  • 3.Ganti AK, Hirsch FR, Wynes MW, et al. Access to Cancer Directed Therapies and Cancer Specialists in Patients with Metastatic Lung Cancer. Oral presentation at the 2015 World Conference on Lung Cancer on September 8.
  • 4.American Cancer Society. Lung Cancer Risks for Non-Smokers. http://www.cancer.org/cancer/news/why-lung-cancer-strikes-nonsmokers.
  • 5.Schiller JH, Bowden CJ, Mills J, et al. Explicit and implicit attitudes toward lung cancer (LC) relative to breast cancer (BC). Program and abstracts of the 2013 Annual Meeting of the American Society of Clinical Oncology; May 31-June 4, 2013; Chicago, Illinois. Abstract 8017.
  • 6.Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening.
  • 7.Schiller JH, Bowden CJ, Mills J, et al. Explicit and implicit associations toward lung cancer (LC) relative to breast cancer (BC). Poster presentation at the 2013 World Conference on Lung Cancer on October 30.
  • 8.Pelosof L, et al. "Increasing Incidence Of Never Smokers In Non-Small Cell Lung Cancer Patients." Oral presentation at the 2015 World Conference on Lung Cancer on September 8.