Evidence map›Paper›PMID 32786189›Full record

ArticleThe New England journal of medicine2020

The Effect of Advances in Lung-Cancer Treatment on Population Mortality.

Nadia Howlader, Gonçalo Forjaz, Meghan J Mooradian, Rafael Meza, Chung Yin Kong, Kathleen A Cronin, Angela B Mariotto, Douglas R Lowy, Eric J Feuer

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 970 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
970citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05715229 phase2recruitingnot on this mapstarted 2023, after this paper: background citation

A Multicenter Phase II Randomized Trial Of Immunotherapy Versus Chemotherapy Guided By Circulating Tumor DNA-Based Molecular Response On Patients With Metastatic NSCLC

TypeinterventionalSponsorHackensack Meridian HealthRan2023 to 2027Enrolled108ConditionsCarcinoma, Non-Small-Cell LungArmsNivolumab, Ipilimumab, Carboplatin, Paclitaxel, Pemetrexed
NCT05798845 phase2recruitingnot on this mapstarted 2025, after this paper: background citation

Exploratory Phase II Clinical Study of Toripalimab Plus Radiotherapy Versus Toripalimab Plus Chemotherapy for the Neoadjuvant Treatment of Operable Stage II-IIIA (N+) Non-small Cell Lung Cancer (NSCLC)

TypeinterventionalSponsorShanghai Chest HospitalRan2025 to 2026Enrolled124ConditionsNSCLCArmsSBRT+LDRT, Toripalimab, Chemotherapy drug
3 · Its place in the literature

Who cites it

970 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Palliative care interventions for thoracic cancer: a systematic review and meta-analysis identifying the core elements.European respiratory review : an official journal of the European Respiratory Society · 2026
    Pooled it
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  6. Chemoradiation ± Atezolizumab in Limited-Stage Small Cell Lung Cancer: Results of NRG Oncology/Alliance LU005.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026
    Trial
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  14. Management of borderline resectable NSCLC: a narrative review.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
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910 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Nadia HowladerFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Gonçalo ForjazFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Meghan J MooradianFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Rafael MezaFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Chung Yin KongFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Kathleen A CroninFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Angela B MariottoFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Douglas R LowyFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).
Eric J FeuerFrom the Surveillance Research Program, Division of Cancer Control and Population Sciences (N.H., G.F., K.A.C., A.B.M., E.J.F.) and Office of the Director (D.R.L.), National Cancer Institute, Bethesda, MD; Massachusetts General Hospital, Harvard Medical School, Boston (M.J.M., C.Y.K.); and the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor (R.M.).

Funding

Intramural NIH HHS Z99 CA999999
6 · The paper itself

Abstract

backgroundLung cancer is made up of distinct subtypes, including non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). Although overall mortality from lung cancer has been declining in the United States, little is known about mortality trends according to cancer subtype at the population level because death certificates do not record subtype information.

methodsUsing data from Surveillance, Epidemiology, and End Results (SEER) areas, we assessed lung-cancer mortality and linked deaths from lung cancer to incident cases in SEER cancer registries. This allowed us to evaluate population-level mortality trends attributed to specific subtypes (incidence-based mortality). We also evaluated lung-cancer incidence and survival according to cancer subtype, sex, and calendar year. Joinpoint software was used to assess changes in incidence and trends in incidence-based mortality.

resultsMortality from NSCLC decreased even faster than the incidence of this subtype, and this decrease was associated with a substantial improvement in survival over time that corresponded to the timing of approval of targeted therapy. Among men, incidence-based mortality from NSCLC decreased 6.3% annually from 2013 through 2016, whereas the incidence decreased 3.1% annually from 2008 through 2016. Corresponding lung cancer-specific survival improved from 26% among men with NSCLC that was diagnosed in 2001 to 35% among those in whom it was diagnosed in 2014. This improvement in survival was found across all races and ethnic groups. Similar patterns were found among women with NSCLC. In contrast, mortality from SCLC declined almost entirely as a result of declining incidence, with no improvement in survival. This result correlates with limited treatment advances for SCLC in the time frame we examined.

conclusionsPopulation-level mortality from NSCLC in the United States fell sharply from 2013 to 2016, and survival after diagnosis improved substantially. Our analysis suggests that a reduction in incidence along with treatment advances - particularly approvals for and use of targeted therapies - is likely to explain the reduction in mortality observed during this period.

Indexed as

Carcinoma, Non-Small-Cell LungFemaleHumansIncidenceLung NeoplasmsMaleMortalitySEER ProgramSex FactorsUnited States

Identifiers

PMID32786189
PMCPMC8577315

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.