Lung cancer is the leading cause of cancer deaths in the country.
Despite strides to better understand and treat the disease it has one of the lowest 5-year survival rates because it’s often caught at a later stage. Over the past decade, the American Lung Association has worked to get a better gauge of the barriers and challenges to proper treatment, care and prevention.
Last week, the ALA released its annual “State of Lung Cancer” report. The report is meant to serve as both a guidepost and rallying call, providing guidance to policymakers and healthcare practitioners.
Kesa Bruce, Director of Advocacy in California, said that the State of Lung Cancer report revealed that there’s not nearly enough Americans being screened.
“There’s a lot of folks that are not being tested for lung cancer, receiving early screenings for lung cancer,” Bruce said. “A lot of folks who are former smokers or current smokers don’t realize that they are at a higher risk and that smoking is a leading risk factor for lung cancer.”
According to Bruce, these early screenings are directly linked to survival rates. Other factors, like radon gas exposure and pollution, can put people at risk for lung cancer. The three cities with the most particle pollution in the United States are all in the San Joaquin Valley here in California.
William Barrett, Assistant Vice President of Nationwide Policy and Clean Air for the American Lung Association explained why these three cities, Fresno, Bakersfield and Visalia, accumulate so much pollution.
“We often think about the San Joaquin Valley as a bowl that can capture pollution. It can essentially sit for days or weeks at a time… You’ve got the agricultural industry with a lot of diesel exhaust and the oil and gas sector,” Barrett said. “All of these kinds of homegrown pollutants can stick around.”
According to the American Lung Association’s 2025 “State of the Air Report,” Los Angeles comes out on top of a different category of pollution for the nation: ozone. While ozone in the stratosphere can help deflect UV radiation from the sun, ground-level ozone can be harmful, according to Barrett.
“We often describe it as thinking about a sunburn on the skin, but in your airways,” he said. “That can trigger a lot of things like asthma attacks and difficulty breathing… 80% or so of the ozone challenge in California comes from the transportation sector, and a very heavy dose of that from diesel engines.”
According to the Environmental Protection Agency, ground-level ozone can build up as a result of nitrogen oxides and volatile organic compounds from car exhaust reacting in the air.
According to the State of The Air report, the EPA has been losing federal funding. According to Barrett, this reflects federal funding cuts across the board.
“We’re seeing a lot of big programs being dismantled, a lot of disinvestment happening not only in air pollution programs nationally, but in science programs and research programs nationally,” he said. “[Become] an advocate, really push for stronger protections for yourself, your community. It’s a really important time for that right now.”
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