The incidence of stage I lung cancer increased between 2010 and 2017 in the United States, according to findings from a study published in Clinical Lung Cancer.
Although this increase was seen across patient subsets, researchers observed “noticeable imbalances” according to race and insurance status. In addition, the increase in stage I disease was mostly seen in patients with non-small cell lung cancer (NSCLC).
The study included 1,447,470 patients diagnosed with lung cancer between 2010 and 2017 from the National Cancer Database. Most patients (84.4%) had NSCLC, 13.8% had small-cell lung cancer (SCLC), and 1.8% had carcinoid tumors.
The percentage of patients with a stage I diagnosis increased from 23.5% in 2010 to 29.1% in 2017. On the other hand, the percentage of patients diagnosed with stage II disease decreased from 9.5% to 8.6%. The percentage of stage III disease decreased from 21.5% to 19.2%, and the percentage of stage IV disease decreased from 45.5% to 43.1%.
The increase in stage I disease was driven mostly by NSCLC, which increased from 25.8% in 2010 to 31.7% in 2017. The percentage of patients with stage I SCLC increased slightly as well, from 5.0% to 5.4%. However, the percentage of stage I carcinoid tumors decreased from 71.7% and 69.2%.
Overall, stage I lung cancer diagnoses increased across age and race groups from 2010 to 2017. However, compared with White patients, Black patients had a 4.7% lower percentage of stage I diagnoses in 2010 and a 5.7% lower percentage of stage I diagnoses in 2017.
Additionally, although patients with all insurance types saw an increase in stage I diagnoses, uninsured patients had the lowest percentages in both 2010 (10.7%) and 2017 (12.9%). In comparison, among patients with Medicare, the percentage of patients with stage I lung cancer increased from 26.0% to 31.4%.
The increased incidence of stage I lung cancer seen in this study is likely due to increased use of low-dose CT for lung cancer screening and detection of incidental pulmonary nodules during routine evaluations, according to the researchers.
Singareddy A, Flanagan ME, Samson PP, et al. Trends in stage I lung cancer. Clin Lung Cancer. Published online November 20, 2022. doi:10.1016/j.cllc.2022.11.005