By Jordan Meadows
Staff Writer
The North Carolina Department of Health and Human Services (NCDHHS) has released the 2025–2030 North Carolina Cancer Plan, outlining an ambitious roadmap to reduce cancer incidence, improve early detection, expand treatment access and support survivors statewide.
With cancer remaining the second leading cause of death in the state, the new five-year plan confronts both the biological and social factors that shape cancer outcomes, with a particular focus on rural and underserved communities that face higher burden.
State Health Director and Chief Medical Officer Dr. Lawrence Greenblatt emphasized the plan’s critical role in addressing these challenges.
“The Cancer Plan is a vital tool in our fight against cancer,” Greenblatt said. “It outlines clear strategies to reduce risk, improve early detection, and expand access to care. We urge communities across the state to use this plan to help save lives.”
The plan focuses on six cancers that have the greatest impact on North Carolinians: lung, female breast, prostate, colorectal, melanoma skin cancers, and HPV-related cancers. Rural residents and communities of color continue to experience higher cancer incidence and mortality, patterns driven in part by social determinants of health such as access to nutritious food, safe housing, transportation, broadband, health care facilities and preventive care.
Dr. Kimberly McDonald, Chief of the Chronic Disease and Injury Section at NCDHHS stated, “Every North Carolinian deserves the opportunity to live a healthy life. That means investing in the conditions that drive health—like access to nutritious food and preventive care.”
Lung cancer—the leading cause of cancer deaths in the United States and responsible for one in five cancer deaths—remains a central focus of the new plan. North Carolina’s lung cancer incidence rate is significantly higher than the national average, with 62.9 cases compared to 53.6 per 100,000 nationwide, according to the American Lung Association. The incidence rate for Black individuals in North Carolina is higher than the national rate for Black populations.
Trends over the past five years show some progress, particularly in early detection. Between 2018 and 2022, early-stage lung cancer diagnosis in North Carolina increased by 10%, partly due to expanded screening efforts following the U.S. Preventive Services Task Force’s 2021 guideline changes. These revised recommendations broadened eligibility for low-dose CT screening, particularly benefiting women and Black adults previously excluded under older criteria.
ECU Health, a major partner in improving access, performed 5,274 low-dose CT screenings in 2023 and 6,151 screenings in 2024. The new Screening Saves program, a partnership between ECU Health and the Lung Cancer Initiative, aims to further expand awareness, education and screening accessibility in eastern North Carolina, a region with historically high lung cancer rates.
Despite these improvements, disparities persist across diagnosis, treatment and survival. From 2018 to 2022, the age-adjusted lung cancer incidence rate in North Carolina was 71.3 per 100,000 among males and 54.0 among females, with non-Hispanic American Indian populations experiencing the highest rates.
Nearly 99% of cases occurred in individuals aged 45 or older, and adults aged 65–84 accounted for the largest share of diagnoses. Treatment patterns also reflect inequities: only 16.4% of Black lung cancer patients in North Carolina underwent surgery, compared to 20% of white patients. Early-stage diagnoses are likewise less common among Black individuals (25.4%) than white individuals (28.8%), underscoring gaps in access to timely screening and care.
At the county level, lung cancer incidence varies significantly. Onslow, McDowell, Richmond, Yadkin and Tyrrell counties report the highest rates, while Watauga, Polk, Avery, Chatham and Camden show the lowest.
The Cancer Plan’s goals highlight a comprehensive push toward reducing risks through healthy behaviors, increasing cancer screenings, improving access to quality treatment, strengthening care coordination and expanding supportive resources for patients and survivors.
Developed by the NCDHHS Division of Public Health’s Comprehensive Cancer Control Program, the Cancer Prevention and Control Branch, and the North Carolina Advisory Committee on Cancer Coordination and Control—with leadership from the NC Cancer Leadership Team—the plan reflects a wide network of partnerships across the state.
Dr. Vickie Fowler, Chair of the NC ACCCC, summarized, “Cancer touches nearly every family in North Carolina, and the burden on our communities is profound. The Cancer Plan is more than a document; it’s a call to action.”
