Incidence, prevalence, and survival of lung cancer in the United Kingdom from 2000-2021: a population-based cohort study
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Background
Lung cancer is the leading cause of cancer-associated mortality worldwide. In the UK, there has been a major reduction in smoking, the leading risk factor for lung cancer, as well as the introduction of the new screening in 2023. Therefore, an up-to-date assessment of the trends of lung cancer is required in the UK.
Methods
We performed a population-based cohort study using the UK primary care Clinical Practice Research Datalink (CPRD) GOLD database, compared with CPRD Aurum. Participants aged 18+ years, with one-year of prior data availability, were included. We estimated lung cancer incidence rates (IR), period prevalence (PP), and survival at one-, five– and ten years after diagnosis using the Kaplan-Meier method.
Results
Overall, 11,388,117 participants, with 45,563 lung cancer cases were studied. The incidence rate of lung cancer was 52.0 (95% CI 51.5 to 52.5) per 100,000 person-years, with incidence increasing from 2000 to 2021, especially in females aged over 50, and males aged over 80, with the highest incidence rate in people aged 80-89. Period prevalence in 2021 was 0.18%, with the largest rise seen in participants aged over 60. Median survival post-diagnosis increased from 6.6 months in those diagnosed between 2000-2004 to 10 months between 2015-2019. Both short and long-term survival was higher in younger cohorts, with 82.7% one-year survival in those aged 18-29, versus 24.2% in the age 90+ cohort. Throughout the study period, survival was longer in females, with a larger increase in survival over time than in males.
Conclusion
The incidence and prevalence of lung cancer diagnoses in the UK have increased, especially in female and older populations, with a small increase in median survival. With the introduction of the UK lung cancer screening programme, this study will enable future comparisons of overall disease burden, so the overall impact may be seen.
