To figure out national rural-urban trends in 5-year cancer-specific survival rate for histologic lung cancer in a diverse sample of tumor stage during 1990-2013. We used data from the Surveillance, Epidemiology, and End Results, the authors examined the 5-year survival rate of urban and rural patients for each histologic type and tumor stage. The Joinpoint Regression Program was used to estimate the trend.

215140 lung cancer patients(median[IQR] age, 69[61-76]; 118108[54.9%]male; 176108[81.9%] White patients; 16248[7.6%] Black patients; 13557[6.3%] Asian patients; 8104[3.8%] Hispanic patients) were analyzed, including 105165 lung adenocarcinoma patients; 58123 lung squamous cell carcinoma patients; 39517 lung small cell carcinoma and 12335 lung large cell carcinoma. There were 36831(17.1%) rural patients. The overall 5-year survival rates increased from 1990 to 2013 for the 4 histological types, with annual percentage change (APC) ranged from 1.24 to 3.04. Compared with other tumor stages within the same histologic cancer, distant lung adenocarcinoma, distant lung squamous cancer, regional small cell lung cancer and regional large cell lung cancer had the highest APC during the observed period (APC=6.22, 3.78, 2.53, 4.46, respectively). However, the 5-year cancer specific survival rate of rural lung adenocarcinoma and lung squamous cell carcinoma consistently fell behind urban counterparts, and the urban-rural disparity remained or even enlarged during the observed period.The result warned us that the urban-rural disparity still needed to be addressed, particularly in lung adenocarcinoma and lung squamous cell carcinoma.