Background: Lung cancer (LC) is often diagnosed at a late stage in relatively old persons whose survival may be compromised because of limited treatment. Our aim was to carry out an age-specific survival study on LC in Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) through a half century (1972-2021). Nordic survival data were compared with survival in the US Surveillance, Epidemiology and End Results (SEER) database

Methods: Relative 1- and 5-year survival data were extracted from the NORDCAN database and subjected to modelling by generalized additive models for survival trends over time. Conditional survival was calculated for those who had survived the first year to survive additional 4 years

Results: Very little improvement was found in survival for any age group before year 2000. By 2017-21, 5-year survival for men below age 50 years has increased to over 40% (FI somewhat less) and for equally aged women it was over 50% in countries other than FI. Survival reached over 20% for the 80-89-year-old male and female patients but it was 7% for men and 12% for women in FI. DK age-group-specific survival curves stayed well parallel to each other indicating equal improvement but for FI and SE men the curves diverged showing increasing age gaps. Nordic age-specific survival data were better than those in the US SEERS

Conclusion: Survival increased, after a 30-year standstill, after 2000 with increasing tempo towards 2017-21 and encompassing all age groups. This and the increase in conditional survival suggested that even the oldest patients were offered effective treatment. As LC remains a fatal disease all prevention modes needs to be emphasized, starting from primary prevention, to early detection and therapeutic improvements.