Kentucky ranks worst in nation for lung cancer: how we got here and the test you should take now

Kentucky's ranking, as worst in the country is an alarming statistic, but hope exists through early detection and advancing treatments.

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Kentucky has earned an unfortunate distinction this year: the worst state in the country for lung cancer. It's a ranking that's both sobering and deeply personal for thousands of families across the Commonwealth.

According to UofL Health, lung cancer remains the leading cause of cancer deaths among both men and women nationwide. But Kentucky's numbers are particularly stark. The American Lung Association reports that Kentucky's rate of new lung cancer cases stands at 84.1- significantly higher than the national rate of 52.8.

"Kentucky has had a problem with lung cancer for a long time, and this year, again, we are on the bottom of the list among the worst of all states in terms of deaths of lung cancer, especially in men," says Dr. Goetz Kloecker, M.D., M.B.A., M.S.P.H., from UofL Health's Brown Cancer Center.

Why Kentucky?

The reasons behind Kentucky's lung cancer crisis are complex, but several factors stand out clearly. Smoking rates tell much of the story- Kentucky's adult smoking rate of 17.4% far exceeds the national average of 11.4%.

"We lead the nation with West Virginia on the number of adult smokers," Dr. Kloecker explains. "It's 50% more than the U.S. average, so smoking is a big problem, causing lung cancer."

But tobacco isn't the only culprit. Kentucky's geology plays a role too. "The other problem in Kentucky is that Radon is relatively common because of the limestone ground… that's adding to the risk of lung cancer in Kentucky," Dr. Kloecker notes. Mining and nutrition issues further compound the problem.

The silent threat

What makes lung cancer particularly dangerous is its stealth nature. "You can have it, but you don't feel it, it doesn't cause any symptoms initially," says Dr. Kloecker. "You would not have any cough, chest pains or breathing problems, but you may already have it in your lungs and to find it, you have to get screened."

This is where the numbers become even more troubling. Of those considered high-risk who should be getting screened, only 21.4% actually are. That's a gap that could mean the difference between life and death.

The guidelines are straightforward: if you're between 50 and 80 years old and have smoked a pack a day for at least 20 years, you should get screened annually. Early detection can find cancer when it's "as small as a dime," Dr. Kloecker says, at a stage where "it can be removed, and you're cured."

Without that early catch, lung cancer's second dangerous feature kicks in- it spreads fast. "If you don't find it early to where you can easily cure it, then it spreads to other parts of your body, it becomes for the most part, incurable," he explains.

Kentucky must do better

The screening gap represents a critical opportunity. "Unfortunately, only a minority between 9 and 20 percent who would be eligible get the CT screening," Dr. Kloecker says. "Kentucky, unfortunately, is falling behind. Other states for screening is more practiced. Kentucky has to do better at finding it at an early stage."

The difference between stages is dramatic. Stage 1 lung cancer offers "the best chance," according to Dr. Kloecker. But once cancer spreads beyond the lung to the brain, liver, or bones, "it's going to be hard without treatment to live longer than a year."

Reasons for hope

Despite these sobering statistics, there's genuine reason for optimism. Treatment advances and clinical trials at Brown Cancer Center are offering new possibilities for patients. Dr. Kloecker points out an almost unbelievable shift in medical history: "Lung cancer, 150 years ago was a very rare disease. Just in the last 100 years of smoking, it became the most common cancer killer, and I dream of a future with modern medicine that we make it go away."

That dream is being pursued through clinical trials that offer cutting-edge treatments, according to UofL Health. "We have clinical trials and this is a way to move forward," says Dr. Kloecker. "We hope we have more patients enrolling in clinical trials to take advantage of the new treatments that we have."

The bottom line

As November marks Lung Cancer Awareness Month, the message from UofL Health is clear and urgent: "We have to educate everybody that by finding it early with a screening, it can be cured."

For Kentuckians, that means taking screening seriously, understanding your risk factors, and talking to your doctor if you meet the criteria. In a state facing the worst lung cancer rates in the nation, early detection isn't just good advice- it could save your life.

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