Characteristics and survival of malignant lung and bronchial tumors: A 45-year analysis based on SEER database

Abstract

Lung cancer is among the leading causes of cancer deaths. Most prior studies have been limited by short follow-up and modest cohorts. Using the Surveillance, Epidemiology, and End Results (SEER) database over four decades, we aimed to describe trends in patient demographics, tumor characteristics, and survival outcomes for malignant lung and bronchial tumors. SEER covers ~28% of the U.S. population and offers anonymized data from 1975–2020. We selected primary malignant lung/bronchial tumors using ICD‑O‑3 codes and examined age, sex, histology, primary site, laterality, and rare tumour types. Overall and disease-specific survival were assessed using Kaplan–Meier and Cox proportional hazards. Nomograms and risk scores were developed; model performance was evaluated with the C-index and ROC curves. Causes of death were determined using SEER cause-specific death classifications. As data were de‑identified, ethical approval was not required. We identified 7,098 eligible cases. Males accounted for 51.5% of patients (P=0.009). Epithelial neoplasms were predominant (88.7%), especially among those aged 55–79, while soft tissue tumors and sarcomas (3.9%) were more frequent in older adults. Median overall survival was 113 months (95% CI: 106–125 months); half of patients survived beyond this period. Survival differed by histology: epithelial tumors (ICD codes 8010‑8049) had a median survival of 110 months (95% CI: 102–125 months). Survival varied little by primary site (p=0.296) or rare tumor category (p=0.098). Laterality showed borderline significance (p=0.050). In this 45‑year population‑based analysis, lung cancer remained a significant cause of mortality. Recognition of demographic and histologic patterns can guide screening and management strategies. Emphasis on early detection and molecularly targeted therapies such as EGFR, ALK, and KRAS inhibitors, alongside immunotherapy, could improve outcomes. Multidisciplinary care and long‑term follow‑up are key to optimizing patient survival.

Keywords

• Lung
• SEER
• Cancer
• Survival
• Malignancy

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