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. 2019 Jan 21:11:943-953.
doi: 10.2147/CMAR.S187317. eCollection 2019.

Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades

Tao Lu  1 , Xiaodong Yang  1 , Yiwei Huang  1 , Mengnan Zhao  1 , Ming Li  1 , Ke Ma  1 , Jiacheng Yin  1 , Cheng Zhan  1 , Qun Wang  1
Affiliations

Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades

Tao Lu et al. Cancer Manag Res. .

Abstract

Purpose: This study used the Surveillance, Epidemiology, and End Results (SEER) data to investigate the changes in incidence, treatment, and survival of lung cancer from 1973 to 2015.

Patients and methods: The clinical and epidemiological data of patients with lung cancer were obtained from the SEER database. Joinpoint regression models were used to estimate the rate changes in lung cancer related to incidence, treatment, and survival.

Results: From 1973 to 2015, the average incidence of lung cancer was 59.0/100,000 person-years. The incidence increased initially, reached a peak in 1992, and then gradually decreased. A higher incidence rate was observed in males than in females and in black patients than in other racial groups. Since 1985, adenocarcinoma became the most prevalent histopathological type. The surgical rate for lung cancer was about 25%, and treatment with chemotherapy showed an increasing trend, while the radiotherapy rate was in downward trend. The surgical rate for non-small-cell lung cancer (NSCLC) was higher than that for small cell lung cancer (SCLC), while chemotherapy for SCLC far exceeded that for NSCLC. Treatment with chemotherapy and radiotherapy for advanced stage had higher rate than early stage. The 5-year relative survival rate of lung cancer increased with time, but <21%.

Conclusion: In the past four decades, the lung cancer incidence increased initially and then gradually decreased. Surgical rate experienced a fluctuant reduction, while the chemotherapy rate was in upward trend. The 5-year relative survival rate increased with years, but was still low.

Keywords: SEER database; incidence; lung cancer; survival; treatment.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The change in incidence trends of lung cancer over years. Notes: (A) The overall trend in the incidence of lung cancer from 1973 to 2015. (B) The sex differences in the incidence of lung cancer. (C) The incidence of lung cancer in different racial groups. (D) The changes in tumor stages from 1988 to 2015. Abbreviation: APC, annual percentage change.
Figure 2
Figure 2
The trends in incidence of four main histopathological types of lung cancer from 1973 to 2015. Abbreviations: ADC, adenocarcinoma; APC, annual percentage change; LCC, large cell carcinoma; SCC, squamous cell carcinoma; SCLC, small cell lung cancer.
Figure 3
Figure 3
The sex differences in the incidence of ADC (A), SCC (B), LCC (C), and SCLC (D). Abbreviations: ADC, adenocarcinoma; APC, annual percentage change; LCC, large cell carcinoma; SCC, squamous cell carcinoma; SCLC, small cell lung cancer.
Figure 4
Figure 4
The rates of surgery, chemotherapy, and radiotherapy for lung cancer over the years. Abbreviation: APC, annual percentage change.
Figure 5
Figure 5
The rates of different treatments for lung cancer over years. Notes: (A) The surgical rates for different histopathological types of lung cancer. (B) The surgical rates for different stages of lung cancer. (C) The rate of chemotherapy for different histopathological types of lung cancer. (D) The rate of chemotherapy for different stages of lung cancer. (E) The rate of radiotherapy for different histopathological types of lung cancer. (F) The rate of radiotherapy for different stages of lung cancer. Abbreviations: ADC, adenocarcinoma; APC, annual percentage change; LCC, large cell carcinoma; SCC, squamous cell carcinoma; SCLC, small cell lung cancer.
Figure 6
Figure 6
The long-term survival of lung cancer patients. Notes: (A) The 5-year relative survival rate of lung cancer from 1973 to 2010. The 5-year relative survival of lung cancer patients by sex (B), race (C), age group (D), histopathological type (E), and different stage (F). Abbreviations: ADC, adenocarcinoma; APC, annual percentage change; LCC, large cell carcinoma; SCC, squamous cell carcinoma; SCLC, small cell lung cancer.
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