Lung cancer
Lung cancer is primarily a result of current and previous years' smoking habits. The picture is still characterised by the fact that smoking was previously more common among men, and that many men started smoking at a young age. This difference in smoking habits is most evident in the oldest age groups, while the middle-aged have about the same proportion of smokers among men as among women.
The number of lung cancer cases is still high, although smoking is declining at the national level. In other words, there are still too many who keep up tobacco consumption and risk.
There is reason to believe that the number of lung cancer cases will decline in the future, but this will not happen without effort. In order for this to happen quickly, it is urgent to quit smoking for even more of those who have passed the age of 40, 50 and 60.
Risk factors
8 out of 10 lung cancers are caused by tobacco use. Lung cancer is therefore one of the types of cancer that is easiest to prevent, namely by quitting smoking or by never starting to smoke at all.
Lung cancer is a disease that can develop over a long period of time, and primarily affects people who smoke, or have smoked previously. It is therefore expected that the number of lung cancer cases will remain high for a long period to come, despite the fact that more and more, especially in the younger part of the population, have chosen to be smoke-free or have stopped smoking.
In geographical areas where the number of smokers is lowest, such as Oslo, one can already see a decline in the number of cancer cases compared to areas with relatively more smokers.
Is there any point quitting for someone who has smoked for a long time? Watch video.
Cancer researcher Tom K. Grimsrud at the Cancer Registry of Norway explains the effect of smoking cessation - and why it is wise to quit, regardless of age.
According to the Norwegian Radiation Protection Authority and the Norwegian Environment Agency , a small number of cases of lung cancer, about 12 percent, can probably be attributed to exposure to radioactive radon gas in the bedrock in several areas of Norway, and it is suggested that this figure is around 370 cases annually.
The risk of lung cancer is particularly high for smokers who are also exposed to radon gas, both because the factors work in their own way, and because the gas connects to particles in the tobacco smoke.
Read the research article Lung cancer incidence associated with radon exposure in Norwegian homes (2017).
Substances such as asbestos are considered risk factors for the development of lung cancer, and especially for those who also smoke. Other risk factors are nickel and chromium exposure, air pollution including diesel exhaust, and passive smoking.
At national level, however, radon and asbestos are considered to be the most important additional burdens on the development of lung cancer, in addition to smoking.
Read more about lung cancer on helsenorge.no
New cases
1696 men and 1623 women contracted lung cancer in Norway in 2023. The number of cases per 100,000 person-years is 55.5 for men and 48.5 for women.
There has been a steady increase in the total number of new cases between 2003 and 2022. For 2023, it may look like there is a small decrease of about 200 cases. The coming years will show whether this is a random variation or the start of a downward trend. It has been predicted that, in line with falling consumption of tobacco smoke in society, there will eventually be a decreasing number of people diagnosed with lung cancer. Projections from NORDCAN have indicated that this breaking point will first occur after the year 2030.
Aging
The median age for lung cancer is 73 years for both sexes, i.e. half of all those diagnosed are over 73 years of age.
Incidence rates for lung cancer by sex and age group 1993-2023. From Fig. 2.2 in the Annual Report of the Lung Cancer Registry of Norway 2023 (Norwegian only)
The figure shows the incidence rates for lung cancer in Norway over the past 30 years. The number of cases is presented on logarithmic scale, because the disease occurs far more frequently among the elderly. In fact, lung cancer is a rare disease before the age of 50. The division between over and under 70 is based on the fact that the average age among those diagnosed with lung cancer has long remained around 70.
The figure also shows two other important points. Firstly, that the incidence rate has long been declining among the younger and middle-aged, most pronounced among men. Secondly, that the incidence rate today is practically the same between women and men in the age groups under 70. Among those over the age of 70, the disease is still somewhat more frequent among men.
Survival
Theincidence rate for patients with lung cancer has almost doubled in the last 20 years and is higher for women than for men. The reason is clear and improved guidelines for assessment, treatment and follow-up of patients.
Five-year relative survival in 2023 is 27.8 percent for men and 34.8 percent for women.
Five-year relative survival from lung cancer 2019-2023 for all stages combined, by sex (From figure 8.2-J in Cancer in Norway 2023
Relative survival of lung cancer up to 15 years after diagnosis, distributed by age in the period 2019-2023. From Fig. 8.2-J in Cancer in Norway 2023.
Survivors with lung cancer
The number of people who have or have had lung cancer as of 31.12.2023 is 11,634 people. 1680 of these were diagnosed more than 10 years ago.
The reason why so few survive is often that lung cancer is detected late and that many can therefore only be offered palliative treatment. However, for the minority who can receive surgical, curative treatment or radiotherapy, survival is significantly better and efforts are constantly being made to further improve the services.
Number of deaths
While the survival rate for lung cancer is increasing, lung cancer is the cancer that takes the most lives. Mortality from lung cancer is also highest among women, followed by breast cancer, colon cancer and pancreatic cancer.
1194 men and 1011 women died of lung cancer in 2022.
The figures show mortality rates for men and women per 100,000 person-years for selected cancers. From Fig. 7.1 in Cancer in Norway 2023.
Development over time
The figure shows trends for men in incidence (dark blue), mortality (light blue) and 5-year relative survival (green) for lung cancer in the period 1965-2023. From figure 9.1-J in Cancer in Norway 2023
The figure shows trends for women in incidence (red), mortality (pink) and 5-year relative survival (brown) for lung cancer in the period 1965-2023. From Figure 9.1-J in Cancer in Norway 2023.
The number of men and women who get lung cancer in Norway has increased sharply in the years after the war. The increase has been particularly large among women, with over twenty times as many reported cases in 2022, compared to the incidence in the 1960s.
Even when we take into account the increase in population and the increase in the proportion of elderly people, we see a tenfold increase in the rates. In the last thirty years alone, there has been close to a doubling of cases when looking at both sexes in total.
Still poor prognosis for those who get lung cancer
The prognosis for those who get lung cancer has been discouraging ever since the 1950s. However, five-year survival has doubled in the last ten years, but lung cancer still has one of the worst prognoses of all cancers.
As for other cancers, the prognosis is significantly better for those diagnosed early in the course of the disease.
National Quality Registry for Lung Cancer
Since 1993, the Cancer Registry of Norway has registered extended information for those who have undergone surgery for lung cancer. Since 2013, the Norwegian Register for Lung Cancer has had national status, and information is collected on all cases of lung cancer.
The quality register collects data on examination and treatment of the patient group. The purpose is to use the data from the register to illustrate practice in hospitals, which can be of help in assessing practice in individual hospitals and for the patient group as a whole.
Read more about the National Quality Register for lung cancer
Example of results from Lungekreftergisteret's latest annual report (2023) (Norwegain only):
Steps you can take to reduce your risk of getting lung cancer
- Avoid smoking
Read about smoking cessation at helsenorge.no - Avoid staying in rooms where someone smokes
Read about passive smoking at helsenorge.no - Avoid exposure to radon
Read about radon and health hazards and measures recommended to reduce exposure to radon at the Norwegian Radiation Protection Authority
Questions about cancer
The Cancer Registry of Norway is a research institution. Our professionals therefore do not answer questions about diagnosis, assessment, treatment and follow-up from patients or their relatives.
Questions about this should be directed to your own GP, treating institution or the Cancer Society Advisory Service tel: 21 49 49 21
