There was a significant increase in the percentage of stage I lung cancer diagnoses between 2010 and 2017, the majority of which were non-small cell lung cancer (NSCLC), according to an analysis of data from the National Cancer Database presented at the 2022 ASCO Annual Meeting.

“The American Cancer Society reported an increase in the percentage of patients with localized lung cancer between 2004 to 2018,” said study presenter Aashray Singareddy, MD, of Washington University of St Louis, St Louis, Missouri. “The sharpest increase really seemed to happen after the [US Preventive Services Task Force] guidelines in 2013-2014. Coinciding with this, the survival for lung cancer also seemed to increase.”

To look at trends in stage distribution, Dr Singareddy and colleagues analyzed data from the more than 1.4 million patients with a lung cancer diagnosis from 1384 hospitals identified in the National Cancer Database. Patients with unknown stage were excluded leaving about 1.39 million patients.

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The percentage of patients with stage I disease increased from 23.5% in 2010 to 29.1% in 2017. Stage IV diagnoses decreased from 45.5% to 43.1% during the same period.

Looking at histology, stage I NSCLC as a percentage of all with this histology increased from 25.9% in 2010 to 31.7% in 2017, but there was little change in stage I small cell lung cancer as the percentage of that histology (from 5.0% to 5.4%).

“We also saw that there were some differences in the stage distribution based on demographic variables, which could be due to disparities in access to diagnosis and treatment,” Dr Singareddy said.

The researchers identified significant imbalances in these increases for certain demographic and socioeconomic groups. Specifically, in 2017, the major gaps in stage I diagnoses included insurance (31.4% for Medicare, 26.4% for private insurance, and 12.9% for uninsured), income (32.4% for the highest annual income and 25.5% for the lowest), and race (30.0% in White individuals and 24.3% in Black individuals).

“We hope that the combination of staging trends and treatment improvements lead to improved survival for patients with lung cancer,” Dr Singareddy concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Singareddy A, Flanagan ME, Samson PP, et al. Trends in stage I lung cancer. Presented at ASCO 2022; June 3-7, 2022. Abstract 10508.