Lung Cancer Toolkit

Lung cancer is not a single disease; rather, it is a group of cancers that originate in the lung and associated tissues. There are several classifications of lung cancer. On a practical basis, lung cancers are clinically divided into two major types, small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC).

Lung cancer is the leading cause of preventable and premature cancer deaths in the United States1 and Indiana. In Indiana, during 2012, approximately 4,674 residents were diagnosed with lung cancer, and 3,958 died as a result of the disease.2

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Who gets Lung Cancer Most Often?

  • Smokers. Lung cancer mortality rates are about 23 times higher for current male smokers and 12 times higher for current female smokers compared to people who have never smoked.3 Over 1 million adults in Indiana still smoke, and Indiana’s adult smoking rate (21.9 percent) remains among the highest in the nation (median adult smoking rate in the United States: 19 percent in 2013).4
  • Those exposed to secondhand smoke. Each year, an estimated 41,000 people in the United States3 and 1,400 Hoosiers5 die from exposure to secondhand smoke (smoke breathed in involuntarily by someone who is not smoking).
  • Those exposed to other cancer-causing agents. Exposure to radon gas is estimated to be the second leading cause of lung cancer in Europe and North America. Exposure to asbestos, certain metals, some organic chemicals, radiation, air pollution, and diesel exhaust may also increase risk. Some occupation-related exposures include rubber manufacturing, paving, roofing, painting, and chimney sweeping.1
  • Males. During 2008-2012, Indiana males, compared to females, had a 50 percent greater lung cancer incidence rate and a 69 percent greater mortality rate. This is mainly because a higher percentage of males have been smokers compared to females.2 In 2013, 23.5 percent of adult males and 20.4 percent of adult females reported being current smokers.4 National data indicate the gap between men and women is narrowing. Women’s disease risks from smoking have risen sharply over the last 50 years, and are now equal to men’s for lung cancer.3

Common Signs and Symptoms of Lung Cancer

Common symptoms include, but aren’t limited to:

  • Persistent cough
  • Sputum streaked with blood
  • Chest pain
  • Voice changes
  • Recurrent pneumonia or bronchitis

Early Detection

The United States Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography in adults aged 55 to 80 years who have a 30 pack per year smoking history and currently smoke, or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years, or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.


Behaviors can have a direct impact on preventing lung cancer. Individuals can:

  • Be smoke free. Quitting tobacco smoking substantially decreases your risk of developing cancer and other chronic diseases. Smokers who quit smoking, regardless of age, live longer than people who continue to smoke.
  • Avoid all secondhand smoke exposure.
  • Visit Indiana’s Tobacco Quitline at, or call 1-800-QUIT-NOW (1-800-784-8669), for free, evidence-based assistance to help quit smoking.

Communities can also help prevent lung cancer by:

  • Support smoke-free air policies and higher taxes on all tobacco products.
  • Support tobacco control program funding to help reduce smoking rates and lessen the health care costs, including approximately $487 million in Medicaid payments alone.
  • Support the continued adoption of smoke-free workplaces. The United States Surgeon General has concluded that smoke-free workplace policies are the only effective way to eliminate exposure to secondhand smoke in the workplace and lead to less smoking among workers.
  • Support health care provider outreach efforts that help decrease tobacco consumption and increase quit attempts.

What Factors Influence Lung Cancer Survival? 

  • Lung cancer is often diagnosed at a later stage, which negatively impacts a person’s odds of survival. The five-year survival rate is highest (54 percent) if the lung cancer is diagnosed when it is confined entirely within the lung (i.e., localized).1 However, in Indiana, during 2008-2012, only 18.7 percent of lung cancers were diagnosed during this stage.2
  • The five-year survival rate is different for SCLC and NSCLC. For SCLC, the five-year survival rate is 6 percent. The five-year survival rate for NSCLC is slightly higher at 18 percent.1
  • Treatment options are determined by the type (small cell or non-small cell) and stage of cancer and include surgery, radiation therapy, chemotherapy and targeted therapies. For localized cancers, surgery is usually the treatment of choice. Because the disease has usually spread by the time it is discovered, radiation therapy and chemotherapy are often used, sometimes in combination with surgery.


Additional Resources:


  1. American Cancer Society. Cancer Facts and Figures 2014. Atlanta: American Cancer Society; 2014. Available online at
  2. Indiana State Cancer Registry Statistics Report Generator. Accessed online at on October 15, 2014.
  3. S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Accessed online at on October 15, 2014.
  4. Indiana State Department of Health, Data Analysis Team. (2014). Indiana Behavioral Risk Factor Surveillance System, 2013.
  5. Zollinger, T., Saywell, R., Lewis, C. Estimating the Economic Impact of Secondhand Smoke on Indiana in 2010. Bowen Research Center – Indiana University School of Medicine, January 2012.