The share of lung cancer cases in the US found at an early stage rose from 18 percent in 2003 to 33 percent in 2023.
The increase sped up after recommendations for annual CT scans for heavy smokers were introduced, and it was seen in every state.
Of those who got lung cancer in the late 1970s, 13 percent were alive after five years, compared with 29 percent of those diagnosed from 2016 to 2022.
More and more lung cancer cases in the US are found before the cancer has spread. In 2003, 18 percent of cases were found at an early stage. In 2023, the share was 33 percent.
The figures come from AACR's annual report on progress against cancer, the Cancer Progress Report 2026. AACR is the American Association for Cancer Research. In the report's chart of lung cancer cases diagnosed at an early stage, 2014 is marked as the year lung cancer screening recommendations were implemented. The journal Nature highlighted the report's figures in a review of the top cancer success stories of the past 50 years.
CT scans for heavy smokers
In late 2013, the USPSTF, the US Preventive Services Task Force, recommended annual low-dose CT scans for people at high risk. The recommendation covered people aged 55 to 80 who had smoked the equivalent of one pack of cigarettes a day for 30 years. They also had to still smoke or have quit within the past 15 years. In 2015, Medicare, the federal health insurance program for older Americans, began paying for the scan. In 2021, the age limit was lowered to 50 and the smoking requirement to 20 years at a pack a day.
We have previously written about how CT scans can catch lung cancer in time.
The increase sped up after 2015
A study in JAMA Oncology shows the same pattern. The researchers went through 4.36 million lung cancer cases from the official US cancer statistics, diagnosed between 2003 and 2022.
Between 2003 and 2014, the share of cases found at an early stage rose slowly, from 17.6 to 20.2 percent. Then it rose faster. In 2016, the share was 24.6 percent, and in 2022 it was 30.1 percent.
The increase was seen in every state. In most, it began around 2016. In 2003, the share ranged from 11.2 to 24.0 percent across states. In 2022, it ranged from 22.0 to 40.2 percent. According to the researchers, more cases have been found early since the screening recommendation was issued, and that is the stage when treatment works best.
Early detection gives more years
For people diagnosed between 2016 and 2022, five-year survival was 65.5 percent when the cancer was only in the lung. When it had spread to other parts of the body, five-year survival was 10.5 percent. These figures come from SEER, the US National Cancer Institute's cancer registry.
Survival for lung cancer as a whole has also increased. Of those diagnosed between 1975 and 1979, 13 percent were alive after five years. Among those diagnosed between 2016 and 2022, the share was 29 percent. According to Nature, the increase is due to better surgery and radiation, and to immunotherapies and drugs that target cancers with specific mutations. For lung cancer that has spread, five-year survival has risen from 2 percent for people diagnosed between 1995 and 1997 to 10 percent for those diagnosed between 2016 and 2022.
The lung cancer death rate in the US fell by an average of 4.2 percent per year between 2015 and 2024. That is faster than for colorectal cancer and female breast cancer, where death rates fell by 1.3 and 1.2 percent per year, respectively. AACR attributes the decline mainly to fewer people smoking, but also to better early detection and treatment.
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