PHOENIX — The American Lung Association graded Arizona’s lung cancer response as mostly below average Tuesday. The association releases an annual report documenting the success or failure in each state’s response to lung cancer awareness.

“The No. 1 modality (for lung cancer) is going to be smoking,” said Dr. Richard Gillespie, a thoracic surgeon at HonorHealth Heart Care – Heart and Lung Surgery – Shea. “It’s No. 1, No. 2, No. 3, but it’s not the only risk.”

The association's report follows a criterion that ranks states on six factors. Arizona ranked above average for rate of new cases; average for early diagnosis; and below average for survival rate, surgical treatment, and lack of treatment and screening.

“Lung cancer is the No. 1 cancer killer,” said American Lung Association Senior Director of Advocacy JoAnna Strother. “It is the leading cause of cancer deaths. We’re just trying to make more people aware that if they are eligible for screening, that they should definitely talk to their provider.”

Those diagnosed with lung cancer can get treatments or surgeries to help lessen their symptoms.

In Arizona, according to the report, 27.1% of people diagnosed with lung cancer are alive after five years, which is lower than the national average of 28.4%.

The rate of new cases in the state, 42.6 per 100,000, is similar to last year and is significantly lower than the national rate of 53.6 – ranking the state seventh among all others.

This year, the rate of new cases has improved by 19% in Arizona and 15% nationally.

Those at high risk for lung cancer in Arizona include adults between the ages of 50 and 80 who smoked a pack of cigarettes a day for 20 years, are current smokers or quit within the last 15 years. About 14% of those high-risk individuals in the state received screenings for lung cancer — compared with the national rate of 16% — ranking the state at 37th.

“People are very independent out here (in Arizona); they don’t want to be told what to do,” Gillespie said. “I think people haven’t heard about screening for lung cancer. It’s a relatively new modality. We as a community need to really be letting people know that this is something that can reduce their risk of lung cancer.”

According to ALA, lung cancer takes the lives of 361 people a day in the U.S. But within the past 10 years, the lung cancer survival rate has increased by 44%.

“Those who are recent immigrants, those who are in some of the less affluent areas of Phoenix just don’t have access to health care,” Gillespie said. “We want to be a part of outreach (and) make sure that we’re providing tools that people need to be able to take care of themselves.”