What is the incidence of Stage 4 (metastatic) lung cancer in the United States (US)?

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Last updated: March 25, 2025View editorial policy

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From the Guidelines

The incidence of Stage 4 (metastatic) lung cancer in the United States is estimated to be around 57-60% of all newly diagnosed lung cancer cases, which translates to approximately 134,000-141,000 new cases annually, based on the estimated 235,760 new cases of lung and bronchial cancer diagnosed in 2021 1.

Key Statistics

  • An estimated 235,760 new cases of lung and bronchial cancer will be diagnosed in the US in 2021, with 131,880 estimated deaths 1.
  • Only 26% of all patients with non–small cell lung cancer (NSCLC) are alive 5 years after diagnosis, and the 5-year relative survival rate for metastatic disease is approximately 6% when patients receive historic cytotoxic chemotherapy regimens 1.
  • However, certain patients with metastatic NSCLC who are eligible for newer targeted therapies or immunotherapies are now surviving longer, with 5-year survival rates ranging from 15% to 50%, depending on the biomarker 1.

Risk Factors and Detection

  • Risk factors for lung cancer include smoking, exposure to secondhand smoke, radon gas, asbestos, and other environmental carcinogens.
  • Early detection through screening with low-dose CT scans for high-risk individuals can help identify lung cancer at earlier, more treatable stages, potentially reducing the incidence of stage 4 diagnoses.

Treatment and Management

  • The NCCN Guidelines for NSCLC address all aspects of management for NSCLC, including recent updates in targeted therapies, immunotherapies, and their respective biomarkers for eligible patients with NSCLC 1.
  • New targeted therapies, such as capmatinib, lorlatinib, pralsetinib, selpercatinib, and fam-trastuzumab deruxtecan, are now recommended in the NCCN Guidelines for eligible patients with metastatic NSCLC who have certain actionable biomarkers 1.

From the Research

Incidence of Stage 4 Lung Cancer in the US

  • The provided studies do not directly report the incidence of Stage 4 (metastatic) lung cancer in the United States.
  • However, it is mentioned that non-small cell lung cancer (NSCLC) accounts for approximately 80-85% of all cases of lung cancer 2, and lung cancer is the leading cause of cancer death in the United States 3.
  • The studies focus on the treatment and management of NSCLC, including targeted therapies and biomarker-directed approaches 2, 3, 4, 5, 6.
  • According to the studies, the 5-year overall survival rate for patients with metastatic NSCLC has improved, with some studies reporting rates exceeding 25% 3 and 40% among patients with ALK-positive tumors 3.
  • The studies emphasize the importance of molecular testing and biomarker-directed therapies in improving overall survival for patients with metastatic NSCLC 3, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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