Progress in Lung Cancer: Rising Survival Rates and Demographic Shifts

In part 1 of an interview with Targeted Oncology, Rebecca Siegel, MPH, cancer epidemiologist and senior scientific director of surveillance research at the American Cancer Society (ACS), discusses the ACS Cancer Facts & Figures 2026 report, of which she was the lead author.

Lung cancer incidence rates in the US have undergone a significant transformation over the past several decades, though the trajectory varies notably by sex and ethnicity. Although there has been a steady decline in diagnoses in men since approximately 1990, women’s rates did not begin to decrease until the mid-2000s. This delayed improvement is largely attributed to historical patterns of tobacco use: Women were much later to adopt smoking in large numbers and have generally been slower to quit. Furthermore, researchers have noted concerning trends in certain birth cohorts, where smoking rates have increased among some groups of young and middle-aged women.

When examining the data through a more granular demographic lens, significant disparities emerge that challenge the overall narrative of progress. Among American Indian and Alaska Native women—who currently maintain the highest smoking rates of any female demographic in the US—lung cancer incidence rates have yet to begin to decline, remaining stubbornly stable. Even more alarming is the trend among Asian American and Pacific Islander women, whose lung cancer incidence rates have been on a slow but consistent rise since 1998. These outliers suggest that although broad public health initiatives are working for many, specific populations require more targeted intervention and study.

In contrast to incidence rates, the mortality landscape offers a much more optimistic picture. Death rates associated with lung cancer have been declining for several decades, with the pace of these declines accelerating significantly over the past 10 years. This shift is primarily driven by massive leaps in survival outcomes. For the first time, approximately 70% of patients diagnosed with lung cancer are reaching the critical 5-year survival milestone, a figure that represents a historic breakthrough in oncology.

This survival surge is the result of 30 years of medical innovation, particularly the development of targeted treatments and immunotherapies. Unlike traditional chemotherapy, which can be broadly destructive to the body, these modern therapies are designed to attack specific genetic markers or leverage the patient’s own immune system to fight the disease. Because these treatments are significantly less toxic, patients can better tolerate them over long periods. This increased durability of treatment allows patients to remain on their regimens longer, directly leading to extended life expectancy and a higher quality of life.

REFERENCE

Siegel RL, Kratzer TB, Wagle NS, Sung H, Jemal A. Cancer statistics, 2026. CA Cancer J Clin. 2026;76(1):e70043. doi:10.3322/caac.70043