Black Americans have the highest death rate and shortest survival rate of any racial or ethnic group in the U.S. for most cancers, according to a 2019 study. Lung cancer is the second most common cancer and the leading cause of cancer death in Black adults, according to the same study.

The rate of new lung cancer cases is higher among Black Kentuckians than Black Americans broadly — 84 per 100,000 versus 60 per 100,000 nationally, according to the American Lung Association. The rate for white Kentuckians is 91, with the state’s overall rate of 89 putting it worst in the nation.

“While Kentucky has made improvements in lung cancer rates, more work clearly needs to be done with increased efforts to help smokers quit and screen at-risk individuals for lung cancer,” said  Virginia “Jenny” Frantz, R.N., OCN, lung patient navigator, Norton Cancer Institute.

Overall, the five-year survival rate for Black Kentuckians with lung cancer is 21%, the same as compared to other Black Americans nationally and is virtually the same for white Kentuckians, according to the American Lung Association’s 2021 “State of Lung Cancer” report. About 20% of Black Kentuckians with lung cancer are diagnosed at an early stage — about the same as Black Americans and white Kentuckians.

Still, about a fifth of Kentucky lung cancer cases are caught before the disease has spread to nearby lymph nodes or metastasized. Nationally, about a quarter of all cases are caught at an early stage.

Black Americans more at risk to continue smoking

While 74% of Black American smokers want to quit, they are typically less successful than other ethnic groups, according to the Center for Black Health & Equity.

The Center for Black Health & Equity suggests possible reasons may include the popularity of mentholated cigarettes that can be more difficult to give up, few cessation resources developed with Black American audiences in mind and unclear research on whether nicotine addiction uniquely affects people of African descent.

“Black Americans with lung cancer were 18% less likely to be diagnosed early, 23% less likely to receive surgical treatment, 9% more likely to not receive any treatment, and 21% less likely to survive five years compared to white Americans,” the lung association said in its 2021 report.

About 28 million Americans lacked health insurance in 2020, according to the U.S. Census, and Black Americans made up about 10% of that group.