Special Populations Affected by Lung Cancer

Lung cancer is a serious disease and is the leading cause of cancer-related deaths in the United States. It is estimated that 224,390 new cases will be diagnosed in 2016, and approximately 158,080 people will die from lung cancer in 2016.1

Within the lung cancer patient population, there are some special groups of patients with noted differences and unique considerations.


While most cases of lung cancer are linked to smoking tobacco, as many as 20% of deaths caused by lung cancer occur in people who do not smoke or use any other form of tobacco (approximately 16,000 to 24,000 Americans every year). Although anti-smoking campaigns implemented in the 1980’s have led to a decrease in smoking-related lung cancers, rates of lung cancer incidence are up among non-smokers. In addition, the lung tumors in non-smokers are often different at a molecular level (specific mutations or changes in the cancer cells) and respond differently to targeted therapy than lung cancers in smokers.1-4


Lung cancer is the second most common cancer in women, with breast cancer occurring more frequently. However, more women die from lung cancer than from breast, uterine, and ovarian cancers combined. Although the overall incidence of lung cancer has been declining, believed to be the positive result of anti-smoking strategies, incidence of lung cancer in women had been increasing for many years. However, now, the rate of lung cancer incidence in women has also begun to decrease. Additionally, some research has suggested several key differences in how lung cancer can develop and respond to treatment in women.1,5-7


Men are more likely to be diagnosed with lung cancer than women, although the overall incidence of lung cancer has been declining in men (and decreasing faster than in women). Lung cancer is the leading cause of cancer-related deaths in both men and women in the U.S., and men are more likely to die from lung cancer than women. There are also differences in the types and genetic mutations commonly found in men with lung cancer.3-5,8

Older or Sick Adults

Lung cancer mostly affects the elderly. It is most commonly diagnosed in people 65-74 years of age. In 2011, 82% of lung cancer patients were 60 years of age or older.6,8 Age is not a significant prognostic factor for overall survival (projected outcome for surviving the disease); the staging of the disease is more relevant to survival rates. The age of the patient also does not affect the response to treatment for most patients, however treatment options for older patients may need to be tailored, depending on their general health and the presence of other health conditions. Some studies suggest the presence of comorbidities (other health conditions) does adversely affect the prognosis of lung cancer and that this negative influence is independent of the age of the patient (the other health conditions are more important than age).9,10 The higher number of comorbidities found in elderly patients makes them less able to tolerate toxic medical treatments, such as chemotherapy, as well as younger patients. However, elderly patients are also at risk for undertreatment (receiving less aggressive cancer treatment), which results in poor survival rates.11

Written by: Emily Downward | Last reviewed: January 2017.
View References
  1. American Cancer Society. Accessed online on 8/17/16 at http://www.cancer.org/.
  2. Thun MJ, Hannan LM, Adams-Campbell LL, Boffetta P, Buring JE, Feskanich D, Flanders WD, Jee SH, Katanoda K, Kolonel LN, Lee IM, Marugame T, Palmer JR, Riboli E, Sobue T, Avila-Tang E, Wilkens LR, Samet JM. Lung cancer occurrence in never-smokers: an analysis of 13 cohorts and 22 cancer registry studies. PLoS Med. 2008 Sep 30;5(9):e185.
  3. Gazdar AF, Thun MJ. Lung cancer, smoke exposure, and sex. J Clin Oncol. 2007;25:469–471.
  4. Medscape. Accessed online on 8/18/16 at http://www.medscape.com/viewarticle/713744.
  5. Centers for Disease Control and Prevention. Accessed online on 8/18/16 at http://www.cdc.gov/.
  6. SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer. National Cancer Institute. Bethesda, MD. Accessed online on 8/1/16 at http://seer.cancer.gov/statfacts/html/lungb.html.
  7. Chakraborty S, Ganti AK, Marr A, Batra SK. Lung cancer in women: role of estrogens. Expert Rev Respir Med. 2010 Aug;4(4):509-518. doi: 10.1586/ers.10.50.
  8. American Lung Association. Accessed online on 8/1/16 at http://www.lung.org.
  9. Hurria A, Kris MG. Management of lung cancer in older adults. CA Cancer J Clin. 2003;53:325-341.
  10. Blanco JAG, Toste IS, Alvarez RF, Cuadrado GR, Gonzalvez AM, Martin IJG. Age, comorbidity, treatment decision and prognosis in lung cancer. Age and Ageing. 2008;37(6):715-718. doi: 10.1093/ageing/afn226.
  11. Maione P, Rossi A, Sacco PC, Bareschino MA, Schettino C. Treating advanced non-small cell lung cancer in the elderly. Ther Adv Med Oncol. 2010 Jul;2(4):251-260. doi: 10.1177/1758834010366707.