The estimated 860 Hawaii residents expected to be diagnosed with lung cancer this year have lower survival rates than their counterparts on the mainland.

The state ranks below average for lung cancer survival rates and early- stage diagnosis, according to the latest report by the American Lung Association.

While a record number of Americans are surviving the disease — with a five-year lung survival rate of 21.7%, up from 17.2%a decade ago — the survival rate for Hawaii residents is 18.7%.

Lung cancer, which often has no early symptoms, has one of the lowest five-year survival rates because by the time the disease is diagnosed, patients are often in the later stages and less likely to be cured, said Carrie Nyssen, senior director of advocacy for the association in Hawaii.

“It’s the No. 1 cancer killer in Hawaii and nationwide,” she said, adding that only 2.7% of local residents are screened for lung cancer, compared with 4.2% nationally. The state’s early-diagnosis rate is 17.6%, compared with the national rate of 21.5%. Cases diagnosed at an early stage have a five-year survival rate of 57.7%.

“To me that’s kind of where the rubber meets the road. We need to reach those high-risk individuals and let them know screening is available to them,” Nyssen said. Annual CT scans among those who qualify can reduce the lung cancer death rate by up to 20%, said the lung association, which is advocating for policies to ensure the tests are covered by Medicaid, the government health insurance program for low-income residents. “If we find it early, they’re more likely to live longer and we can treat it.”

High-risk patients are people 55 to 80 years old who smoked a pack of cigarettes every day for 30 years or two packs per day for 15 years. Lung cancer patients, diagnosed at an early stage, often can be treated with surgery. Locally, 18.6% of patients had surgery versus 20.6% nationally.