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Michael Gieske: Seeking equity for lung cancer research funding; KY has high morbidity rate

Lung Cancer remains the deadliest of the major cancers, killing more Americans than breast, colon, and prostate cancer combined. Lung cancer kills 3 times as many women as breast cancer. Each year over 235,000 individuals are diagnosed with lung cancer; each day over 350 of our friends and family die from lung cancer. Lung cancer is so deadly because of its aggressive fast-moving nature, that historically is most often found in the late stages when it has become symptomatic. Though outcomes are improving, still less than one fourth the patients diagnosed with lung cancer survive more than 5 years.

In Kentucky, the statistics are especially dismal. We have the highest incidence and mortality from lung cancer in the country. Only 4 states have worse 5-year survival rates. We battle with West Virginia for the highest percentage of adults in the state that smoke.

Dr. Michael Gieske

The good news is that we are making progress with prevention and decreased smoking rates, with early detection through low-dose CT lung cancer screening, and greatly improved treatments including surgery, radiation treatment, targeted precision pharmaceuticals, and immunotherapy. We now have many 10 to 15 year survivors with late-stage lung cancer. We know that up to 20 % of lung cancers are not related to smoking, that anyone with lungs can get lung cancer. We know there are many other risk factors for lung cancer, including Radon, secondhand smoke, family history, and genetic mutations, to name a few. All these efforts are aided and immeasurably impacted by research and the funding through the CDMRP (Congressionally Directed Medical Research Program) that appropriates high quality research efforts through the Lung Cancer Research Program (LCRP). Presently in the FY 2022 budget, lung cancer research receives 20 million dollars, compared to 150 million for breast cancer. This level of funding was only able to fund one third of the highly qualified lung cancer research opportunities.

Lung Cancer Action Network (LungCAN), a grassroots coalition of lung cancer organizations and advocacy groups, and our team has had the distinct honor to meet with Senator Mitch McConnell and Representative Hal Roger’s offices to discuss this landmark initiative. They each sit on their respective chamber’s Department of Defense Appropriations Sub-committee.

Kentucky leads the nation in lung cancer state-based initiatives, including the KY LEADS Collaborative, the KY Health Collaborative, the Kentucky Cancer Consortium, and the KY Cancer Program. Soon, 10 hospital systems will be sharing de-identified lung cancer and screening data across our state to improve outcomes and the statistics for our state. The Kentucky legislature passed House Bill 219 to support lung cancer screening and to provide an advisory committee for lung cancer screening in our state, perhaps the first in the nation to do so. Kentucky is leading the way in the organizations that have signed onto the LungCAN CDMRP letter to request an increase from 20 to 60 million dollars, with 16 of the 80 endorsements coming from our state.

St. Elizabeth Healthcare has a very robust and well-coordinated lung cancer screening program, having performed over 25,000 screens since the inception of the program in 2013, finding over 380 lung cancers, or one lung cancer for every 62 screens completed. We are on track to exceed 8,000 screens this year.

The especially good news is that 56% of the cancers found are in stage I, when the cure can exceed 90%; 70% are found in the early stages (stages I and II). Our team will be presenting our results with a scientific abstract and poster at the World Conference on Lung Cancer in Vienna, Austria this August. We are involved closely with the American Cancer Society, National Lung Cancer Round Table, American Lung Association, American College of Radiology, GO2 Foundation, Lung Ambition Alliance, many lung cancer survivor and advocacy groups, and others, as well as all the great organizations in Kentucky.

The state of Kentucky is making a difference and we are getting recognized on a national and international level. We are now at the top of a healthcare list, in the #2 position for lung cancer screening in the country, with a good chance of being #1 by the end of the year. We are helping to deliver a profound message of hope to patients at risk for lung cancer and those with lung cancer. This message can only be improved with increased research funding for the LCRP through CDMRP appropriations.

We are asking Kentucky’s Congressional leaders to help close the gap in lung cancer funding, making it more proportionate to the devastating impact of this disease, so we can further improve the outcomes and reduce the costs for our state and our country.

We further implore that Kentucky be given the means to continue to be that beacon of hope and example to the rest of the country, the rest of the world.

Please give due consideration to increasing FY 2023 CDMRP LCRP funding from 20 to 60 million dollars.

An increase in funding will ensure clinically demonstrable results with improved survival rates, enhanced screening and early detection of lung cancers that will yield better outcomes nationwide.

Michael Gieske, MD, is director of Lung Cancer Screening at St. Elizabeth Healthcare. He is a family practitioner and a member of St. Elizabeth Physicians.

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