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Using the Japanese National Cancer Registry (NCR) cohort of patients registered between 2016 and 2020, the study classified cases as Screening, Incidental, and Other. Among 563,244 eligible patients, 1–3 year net survival differed substantially, highest in Screening and lowest in Other, with localized disease showing the strongest survival advantage.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/survival-by-detection-pathway-in-patients-with-lung-cancer-a-nationwide-descriptive-epidemiological-study-in-japan/354333/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/survival-by-detection-pathway-in-patients-with-lung-cancer-a-nationwide-descriptive-epidemiological-study-in-japan/354333.png","ImageObject",300,407,{"name":92,"@type":93},"Elsa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"How were patients with lung cancer categorized in this study?","Question",{"text":112,"@type":113},"Patients were grouped by detection pathway into Screening, Incidental, and Other groups.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What were the main findings for 3-year net survival across the detection pathways?",{"text":117,"@type":113},"The 3-year net survival was highest in the Screening group (75.2%), intermediate in the Incidental group (56.3%), and lowest in the Other group (29.4%).",{"name":119,"@type":110,"acceptedAnswer":120},"How did stage at diagnosis relate to survival in the detection pathways?",{"text":121,"@type":113},"In subgroup analysis for localized disease, 3-year net survival remained very high across groups, with the Screening group showing the greatest value (96.3%).",{"name":123,"@type":110,"acceptedAnswer":124},"What does the study suggest about screening’s role in lung cancer outcomes?",{"text":125,"@type":113},"Screening likely supports earlier detection and contributes to improved survival outcomes among lung cancer patients in Japan.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},354333,1790171431,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","International Journal of Cancer  \nRESEARCH ARTICLE  OPEN ACCESS   \nCancer Epidemiology  \nSurvival by Detection Pathway in Patients With Lung Cancer—A Nationwide Descriptive Epidemiological Study in Japan  \nRyo Koto1  | Atsuki Yamamoto1 | Ikumi Takashima1 | Chikako Iwao1  | Jung-ho Shin1 | Yuko Hayashi1 | Hiroshi Kitagawa1  | Yoshiharu Horie1,2   \n1Medical Department, AstraZeneca K.K. , Osaka, Japan | 2Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Suita, Japan  \nCorrespondence: Yoshiharu Horie ([yoshiharu.horie@astrazeneca.com](yoshiharu.horie@astrazeneca.com))  \nReceived: 10 September 2025 | Revised: 11 March 2026 | Accepted: 27 March 2026  \nKeywords: cancer epidemiology | lung cancer | population-based registry | screening | survival  \nABSTRACT  \nGreater understanding of the prognosis for patients with lung cancer in Japan according to detection pathway would clarify the effect of population-based screening programs and the related diagnostic environment. We explored the clinical characteristics and net survival (NS) of patients with lung cancer by detection pathway with Japanese National Cancer Registry (NCR) database of patients registered between 2016 and 2020. Eligible patients were categorized based on detection pathway: Screening, Incidental, and Other groups. We estimated 1, 2, and 3 year NS. Of 565,044 patients with lung cancer in the NCR, 563,244 met the eligibility criteria and were included in this study: 95,081 patients in the Screening (16.9%), 254,569 in the Incidental (45.2%), and 200,850 in the Other groups (35.7%). In the Screening, Incidental, and Other groups, 69.5%, 88.6%, and 83.4% of patients, respectively, were aged ≥65years, and 50.5%, 49.6%, and 14.0% of patients, respectively, had localized disease at diagnosis. The most common initial treatment was surgery in the Screening (62.5%) and Incidental (46.2%) groups, while chemotherapy was most frequently used in the Other group (48.6%) . The 3 year NS was 75.2%(95% confidence interval: 74.9%–75.6%) in the Screening group, 56.3%(56.0%–56.6%) in the Incidental group, and 29.4%(29.2%–29.7%) in the Other group. In the subgroup analysis, 3 year NS for localized disease was 96.3%(95.9%–96.7%), 83.9%(83.6%–84.3%), and 76.9%(76.1%–77.6%), respectively, for the Screening, Incidental, and Other groups. Screening may play a key role in early detection and is likely to contribute to survival outcomes.  \n1 | Introduction  \nEarly detection of lung cancer is critical for improving patient prognosis. A previous study showed that the 5 year survival rate exceeds 75% for patients with lung cancer detected at an early stage [1], and tumor stage (Tumor, Node, and Metastasis stage or clinical stage) is recognized as one of the main factors affecting prognosis [2] . Other characteristics such as age, sex, treatment modality, smoking history, histological type, histological  \nsubgroup (non-small cell lung cancer [NSCLC] and small cell lung cancer [SCLC]) have also been identified as prognostic factors [3, 4]. The favorable prognosis of early stage lung cancer is mainly due to the possibility of receiving curative interventions, such as surgical resection [4] .  \nLung cancer can be detected through screening, incidental findings such as during follow-up for other conditions, or presentation with cancer-related symptoms; screening programs  \n\n| Abbreviations: CI, confidence interval; CT, computed tomography; DCO, death certificates only; FAS, full analysis set; ICD-10, International Classification of Diseases, 10th revision; LDCT, low-dose CT; NCR, National Cancer Registry; NS, net survival; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer. Some results in the present manuscript were reported at the 2025 Japanese Society of Medical Oncology Annual Meeting (March 6–8, 2025; Kobe, Japan) . |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License,","cbCaingy5jxkU9LU","https://ap.wps.com/l/cbCaingy5jxkU9LU","pdf",418001,11,"English","# Abstract\n# Introduction\n## Detection pathways and prognosis background\n# What's New?\n## Key findings on screening impact\n# Data and outcomes\n## Cohort selection and net survival comparisons","[{\"question\":\"How were patients with lung cancer categorized in this study?\",\"answer\":\"Patients were grouped by detection pathway into Screening, Incidental, and Other groups.\"},{\"question\":\"What were the main findings for 3-year net survival across the detection pathways?\",\"answer\":\"The 3-year net survival was highest in the Screening group (75.2%), intermediate in the Incidental group (56.3%), and lowest in the Other group (29.4%).\"},{\"question\":\"How did stage at diagnosis relate to survival in the detection pathways?\",\"answer\":\"In subgroup analysis for localized disease, 3-year net survival remained very high across groups, with the Screening group showing the greatest value (96.3%).\"},{\"question\":\"What does the study suggest about screening’s role in lung cancer outcomes?\",\"answer\":\"Screening likely supports earlier detection and contributes to improved survival outcomes among lung cancer patients in Japan.\"}]","Survival by Detection Pathway in Patients With Lung Cancer - A Nationwide Descriptive Epidemiological Study in Japan | PDF",1790110159,28]