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.


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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. 

Reference

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