Non-Small Cell Lung Cancer Coverage from Every Angle
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Update on Population-Level Mortality Rates in Lung Cancer

By: Kelly M. Hennessey, PhD
Posted: Tuesday, November 17, 2020

National mortality rates for non–small cell lung cancer (NSCLC) are decreasing faster than its incidence and may be attributed to improved targeted therapies. Eric J. Feuer, PhD, of the National Cancer Institute, Bethesda, Maryland, and colleagues reviewed the incidence data from the Surveillance, Epidemiology, and End Results (SEER) cancer database to estimate lung cancer mortality trends by lung cancer subtypes. They found improved survival rates in patients with NSCLC across all groups, yet only a decline in incidence was observed for patients with small-cell lung cancer. Their results were published in The New England Journal of Medicine.

Researchers evaluated population-level U.S. mortality trends by sex and lung cancer type from 2001 to 2016. By using the incidence-based mortality approach, they separated data from lung cancer into disease subtypes. Using this approach, researchers could exclude deaths from cancers that metastasized to the lungs from other sites. They found that mortality from lung cancer is actually lower than what is reported on death certificates.

In men, the incidence of NSCLC decreased by 1.9% annually from 2001 through 2008 and decreased by 3.1% annually from 2008 to 2016. Correspondingly, incidence-based mortality decreased by 3.2% annually from 2006 to 2013 and then decreased rapidly by 6.3% per year from 2013 to 2016. This finding was consistent among all races and ethnic groups, and similar patterns were found between men and women. Accelerated decline correlated with routine testing for the presence of mutations in the genes encoding ALK or EGFR and resulting targeted therapies and immunotherapies. Although clinical studies have shown a survival benefit in patients with NSCLC with targeted therapies, this study highlights their effect at the population level.

Disclosure: For full disclosures of the study authors, visit nejm.org.



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