How common is non-small cell lung cancer (NSCLC)?

Together, SCLC and NSCLC account for more than 95% of all lung cancers. On its own, NSCLC accounts for up to 85% of all lung cancers in the United States.

According to the American Cancer Society (ACS), lung cancer is the second most common cancer in the United States, with around 238,340 new cases predicted for 2023.

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There are three main subtypes of NSCLC:

• Adenocarcinoma: This is the most common type of primary lung cancer, accounting for around 40% of all lung cancer cases. It is the leading cause of cancer death in the U.S., and it is the most common lung cancer among people who have never smoked.
• Squamous cell carcinoma (SCC): This is the second most common type of NSCLC, accounting for about 25% of all lung cancer cases. This subtype links to smoking, and it is more common among women.
• Large cell carcinoma (LCC): This type accounts for approximately 10% of all lung cancer cases. This subtype can appear on any part of the lung and tends to grow and spread rapidly.

Learn more about lung cancer.

Below are some of the risk factors associated with NSCLC.

Age

Although the average age for NSCLC diagnosis is 70 years old, one older 2015 study suggests that some cases appear in people younger than 40.

Some factors associated with NSCLC cases in younger people include:

• being female
• being Asian or Pacific Islander
• having adenocarcinoma

Sex

Compared with males, females appear to have an increased risk of NSCLC complications. According to a 2021 review, this may be due to the overexpression of the hormone receptor estrogen-related receptor alpha, which is receptive to the hormone estrogen.

Race

Black men have a 12% higher risk of developing lung cancer than white men. Black women are 16% less likely to develop lung cancer than white women.

A 2019 study found that Black people with NSCLC had more mutational changes in their DNA than people of other ethnicities. However, one 2020 study states there is no difference in NSCLC treatment and survival when Black people and white people receive equal access to treatment.

Smoking

According to the Centers for Disease Control and Prevention (CDC), people who smoke are 15–30 times more likely to develop or die from lung cancer than people who have never smoked.

The CDC also notes that around 80–90% of deaths from lung cancer link to smoking. This risk increases with the number of years a person smokes and the number of cigarettes they smoke each day.

Exposure to secondhand smoke

Most people with lung cancer who do not smoke develop NSCLC as opposed to SCLC. The most common NSCLC subtype among people who do not smoke is adenocarcinoma.

A 2017 study of people in Korea with NSCLC found that roughly 38% of NSCLC cases occurred in people who had never smoked.

Exposure to secondhand smoke accounts for around 15–35% of lung cancer cases among people who have never smoked.

Exposure to toxic substances

Exposure to the following substances increases the risk of lung cancer:

• asbestos
• radon
• heavy metals, such as arsenic and chromium

Radon exposure is the leading cause of lung cancer among people who do not smoke. However, exposure links to an increase in the risk of SCLC rather than NSCLC.

The 5-year survival rate refers to the percentage of people who live 5 years or more following their initial cancer diagnosis. According to the ACS survival statistics, NSCLC has a 5-year survival rate of 28%, while SCLC has a 5-year survival rate of 7%.

Five-year survival rates vary according to lung cancer stage, which is the extent to which the cancer has spread. The three stages and their associated survival rates are as follows:

• Localized disease: This is cancer that has not spread outside the lungs. The 5-year survival rate for NSCLC at this stage is 65%.
• Regional disease: This is cancer that has spread to nearby areas outside the lung. The 5-year survival rate for NSCLC at this stage is 37%.
• Distant disease: This is cancer that has spread to distant areas. The 5-year survival rate for NSCLC at this stage is 9%.

According to a 2020 review, the following factors have significantly improved treatment outcomes and survival rates among people with NSCLC:

• earlier diagnosis
• a more accurate and detailed classification system for lung cancers
• advances in treatment

The number of new lung cancer cases continues to decrease over time, likely because more people are quitting smoking or never starting. The number of deaths from lung cancer is also decreasing for this reason, in addition to advances in detection and treatment.

However, at the time of this article’s publication, there is a decline in cases of SCC and a continuous rise in cases of adenocarcinoma.

The decline in SCC is likely due to increases in the number of people giving up smoking or choosing never to begin smoking. The cause of the rise in adenocarcinoma is currently under investigation.

One 2020 study found an increase in lung cancer incidence among young women, driven by increasing rates of adenocarcinoma.

The ACS predicts that approximately 238,340 people in the U.S. will receive a diagnosis of lung cancer in 2023.

Generally, lung cancer incidence and mortality rates are slowly declining. However, the pace of decline is faster among males than among females, and it started at least a decade earlier for men than women.

Some research suggests that women may be less likely to quit smoking than men, which may account for the sex differences in lung cancer rates.

Quitting smoking plays an important role in lung cancer outlook. A 2020 study suggests that quitting smoking anytime can reduce a person’s risk of dying from lung cancer.

The greater the elapsed time between quitting smoking and lung cancer diagnosis, the greater the odds of survival, as outlined below:

• Quitting fewer than 2 years before diagnosis: This has a 12% reduced mortality risk.
• Quitting 2–5 years before diagnosis: This has a 17% reduced risk of mortality.
• Quitting more than 5 years before diagnosis: This has a 20% reduced mortality risk.

NSCLC is the most common type of lung cancer. It has three subtypes: adenocarcinoma, SCC, and LCC.

The incidence of NSCLC has changed over time. Subtypes associated with smoking are declining as more people are giving up smoking or choosing never to smoke in the first place.

Survival rates for NSCLC are improving thanks to earlier diagnoses, more accurate and detailed disease classification, and advances in lung cancer treatment.