New Report: West Virginia Worst in Nation for Adult Smoking, 2nd Worst for New Lung Cancer Cases; Survival Improving But Still Below Average; Biomarker Testing Coverage Needed

Today, the American Lung Association in West Virginia released the 2025 “State of Lung Cancer” report, which reveals that more needs to be done to end the burden of this devastating disease on families throughout the state. Lung cancer is the leading cause of cancer deaths here in West Virginia and across the U.S. The report finds that West Virginia has the highest rate of adult smoking rates at 20.4% currently smoking and the second highest rate of the new lung cancer cases in the country (50 out of 51 states including D.C.), just behind Kentucky, which ranks worst. The state is also below average for high-risk screening (38 out of 51 at 15.4%) and survival at (33 out of 39 at 25.5%) but shows a 27% improvement over the past five years. 

The Lung Association’s eighth annual “State of Lung Cancer” report highlights how the toll of lung cancer varies by state and examines key indicators throughout the U.S., including new cases, survival, early diagnosis, surgical treatment, lack of treatment, screening rates and insurance coverage of comprehensive biomarker testing.

The report found that West Virginia ranks:

• 50 out of 51 in the nation for rate of new lung cancer cases, at 76.3 per 100,000. The national rate is 52.8 per 100,000.
• 33 out of 39 in the nation for survival, at 25.5%, which marks a 27% improvement over the past five years. The national rate of people alive five years after a lung cancer diagnosis is 29.7%.
• 26 out of 50 in the nation for early diagnosis, at 28.4%, which marks a 13% improvement over past five years. Nationally, only 28.1% of cases are diagnosed at an early stage when the survival rate is much higher.
• 38 out of 51 in the nation for lung cancer screening, at 15.4%. Lung cancer screening with annual low-dose CT scans for people at high risk can reduce the lung cancer death rate by up to 20%. Nationally, only 18.2% of people at high risk were screened.
• 21 out of 49 in the nation for surgery as first course of treatment, at 20.7%. Lung cancer can often be treated with surgery if it is diagnosed at an early stage and has not spread. Nationally, 20.7% of cases underwent surgery.
• 38 out of 49 in the nation for lack of treatment, at 23.6%. Nationally, 21% of cases receive no treatment.
• 51 out of 51 in the nation for adults who smoke, at 20.4%. Nationally, 11.4% of adults currently smoke.

“In the last decade, we have seen incredible progress, including increases in lung cancer survival and early detection rates. This means that more people in West Virginia are living longer after a lung cancer diagnosis,” said Elizabeth Hensil, director of advocacy for the American Lung Association. “While this progress gives us hope, early detection and survival rates are far too low in our state. Working to increase awareness and access to lung cancer screening and biomarker testing are critical to saving lives. This is why the state must take steps to ensure their residents have access to the best lung cancer care.”

The “State of Lung Cancer” report also examines insurance coverage of comprehensive biomarker testing across the U.S. Lung cancer biomarker testing, sometimes referred to as tumor, molecular, genomic or genetic testing, looks for changes in the tumor's DNA. The results of the test may show biomarkers that can help determine what treatment options would be best for an individual patient. Insurance coverage of biomarker testing is important for removing a cost barrier to people with lung cancer, but coverage for biomarker testing is only required in some states. The report found that West Virginia does not require insurance coverage of comprehensive biomarker testing.

The 2025 “State of Lung Cancer” report highlights opportunities for states to reduce the burden of lung cancer and encourages everyone to help end lung cancer. This year, the American Lung Association calls for the state to implement policies to require insurance coverage of comprehensive biomarker testing. Learn more about the report and take action at Lung.org/solc.