ArticleJNCI cancer spectrum2026
Trends in lung cancer survival: superior outcomes in US Veterans compared with the general population.
Article in JNCI cancer spectrum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Reconsidering community care referrals for Veterans with lung cancer.JNCI cancer spectrum · 2026Article
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18 authors.
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Abstract
backgroundNon-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality in the United States, but survival outcomes are shifting with evolving therapies and screening. Recent findings suggest that survival improvements vary across health-care systems, with favorable trends observed in the Veterans Health Administration (VHA). We sought to compare NSCLC survival trends across US health systems.
methodsWe conducted a retrospective cohort study of patients with NSCLC (2007-2019) using data from the VHA and the National Cancer Database (NCDB), representing the non-VHA US general population. The primary exposure was health system (VHA vs non-VHA), and the primary outcome was 3-year all-cause mortality. Multivariable Cox models estimated annual adjusted overall survival (OS), with interaction terms for health system and stage.
resultsAmong 1 463 996 patients (VHA n = 79 027; NCDB n = 1 38 4 969), adjusted 3-year OS increased from 24% to 51% (VHA) and from 24% to 41% (non-VHA) between 2007 and 2019. The VHA survival advantage persisted in analyses stratified by stage (all P-values <.0001) and when analyses were limited to NCDB patients with Medicare or private insurance (51% vs 42% in 2019; P < .0001).
conclusionsIn this nationally representative study, 3-year OS among patients with NSCLC improved between 2007 and 2019, with larger and more rapid gains observed within the VHA compared with non-VHA settings. These findings suggest that lung cancer care delivered within an integrated, publicly funded system is associated with greater and more rapidly improving survival than care delivered across a heterogeneous mix of US health-care delivery settings represented in the NCDB.
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