A Snapshot of Lung Cancer
Incidence and Mortality
Lung cancer is the second most common cancer and the primary cause of cancer-related death in both men and women in the United States. The overall mortality rate for lung and bronchus cancers rose steadily through the 1980s, peaked in the early 1990s, and has been slowly declining since 2001. Trends in lung cancer incidence and mortality rates have closely mirrored historical patterns of smoking prevalence, after accounting for a lag period. Because the prevalence of smoking peaked later in women than in men, lung cancer incidence and mortality rates began declining later for women than men. The incidence rate has been declining since the mid-1980s in men but only since the mid-2000s in women; the mortality rate began declining in 1991 in men and but not until 2003 in women. Incidence and mortality rates are highest among African American men, followed by white men.
Although smoking is the main cause of lung cancer, lung cancer risk also is increased by exposure to secondhand smoke; environmental exposures, such as radon, workplace toxins (e.g., asbestos, arsenic), and air pollution. The risk of lung cancer can be reduced by quitting smoking and by eliminating or reducing exposure to secondhand smoke and environmental and workplace risk factors. The National Lung Screening Trial has shown that screening current or former heavy smokers with low-dose helical computed tomography (CT) decreases their risk of dying from lung cancer. Standard treatments for lung cancer include surgery, radiation therapy, chemotherapy, targeted therapy, laser therapy, photodynamic therapy, cryosurgery, endoscopic stent placement, and electrocautery.
Assuming that incidence and survival rates follow recent trends, it is estimated that $11.9 billion1 will be spent on lung cancer care in the United States in 2014.
Examples of NCI Activities Relevant to Lung Cancer
- Researchers with The Cancer Genome Atlas (TCGA) program are systematically identifying the major genomic changes involved in more than 20 cancers, including adenocarcinomas and squamous cell carcinomas of the lung, using state-of-the-art genomic technologies. In addition, the TCGA Pan-Cancer analysis project is comparing mutations across tumor types to identify genomic similarities; such similarities would raise the prospect that similar treatments could be useful for multiple cancer types. [PubMed Abstract]
- The Lung Cancer Master Protocol (Lung-MAP) study is a multi-arm, multi-drug trial for patients with advanced non-small cell lung cancer that has not responded to standard treatment. This trial is unique in that it will test patients for several biomarkers by using genomic profiling, then assign patients to a new investigational treatment that specifically targets the genomic alteration that may be driving the growth of their cancer.
- The Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials (ALCHEMIST) will identify early-stage lung cancer patients with tumors that harbor certain uncommon genetic changes and evaluate whether drug treatments targeted against those changes can lead to improved survival.
- Follow-up studies are ongoing for the National Lung Screening Trial, which compared two ways of detecting lung cancer among people aged 55 to 74 with a history of heavy smoking: low-dose helical CT and standard chest X-ray. The results to date show that participants who were screened with low-dose helical CT had a 20 percent lower risk of dying from lung cancer than participants who were screened with standard chest X-ray.
- The Physical Sciences-Oncology Centers program is bringing together cancer biologists, oncologists, and researchers from disciplines in the physical sciences to address major questions and barriers in cancer research. One center is using mathematical models to study the evolution of brain, lung, and hematologic cancers.
- The phase II trial Mithramycin for Lung, Esophagus, and Other Chest Cancers is examining whether mithramycin is a safe and effective drug against different chest cancers, including lung cancer.
- Seven lung cancer–specific Specialized Programs of Research Excellence (SPOREs) are characterizing the molecular heterogeneity of lung cancer, identifying new biomarkers of treatment response, investigating chemopreventive agents, and pursuing new treatments.
Selected Advances in Lung Cancer Research
- Two transcription factors, GATA6 and HOPX, are critical nodes in a lung cell differentiation pathway that also inhibits the progression of lung adenocarcinoma. Published May 2013. [PubMed Abstract]
- A small-molecule inhibitor of the antioxidant pathway protein SOD1 impairs the growth of, and induces cell death in, human non-small cell lung cancer cell lines and reduces tumor burden in a mouse model that recapitulates human non-small cell lung cancer. Published January 2014. [PubMed Abstract]
- Non-small cell lung cancers that harbor EGFR-activating mutations can become resistant to EGFR tyrosine kinase inhibitor chemotherapies by overexpressing the protein CRIPTO1. Published June 2014. [PubMed Abstract]
- A comprehensive molecular profile of 230 resected lung adenocarcinomas identified somatic mutations and alterations in mRNA processing, establishing a foundation for additional investigations into the development and progression of lung cancer. Published July 2014. [PubMed Abstract]
Trends in NCI Funding for Lung Cancer Research
NCI’s investment2 in lung cancer research was $285.9 million in fiscal year (FY) 2013. In addition to the funding described in the graph, NCI supported $69.3 million in lung cancer research in FYs 2009 and 2010 using funding from the American Recovery and Reinvestment Act.
Additional Resources for Lung Cancer
- What You Need To Know About™ Lung Cancer
Describes treatment options, types of cancer doctors, second opinion, follow-up care, and sources of support for someone recently diagnosed with lung cancer.
- Lung Cancer Home Page
NCI's gateway for information about lung cancer.
- Harms of Smoking and Health Benefits of Quitting
A fact sheet that lists some of the cancer-causing chemicals in tobacco smoke and describes the health problems caused by smoking and the benefits of quitting.
- SmokeFree Teen
A resource to help teen smokers quit and offers tailored information, several social media pages to connect teens with cessation tools, and a free smartphone application.
- QuitSTART App
A free smartphone app from Smokefree Teen that can help you track cravings and moods, monitor progress, and identify smoking triggers.
A mobile text messaging service designed for adults and young adults across the United States who are trying to quit smoking.
- NLST Guide for Patients and Physicians
A one-page guide to the benefits and harms of low-dose helical CT based on NLST results.
- Non-Small Cell Lung Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of non-small cell lung cancer.
- Small Cell Lung Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of small cell lung cancer.
- Clinical Trials for Non-Small Cell Lung Cancer
- Clinical Trials for Small Cell Lung Cancer
- 1 Cancer Prevalence and Cost of Care Projections, in 2010 dollars.
- 2 The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.