Who Gets Small-Cell Lung Cancer?

Medically Reviewed by Sabrina Felson, MD on July 27, 2022
4 min read

Small-cell lung cancer (SCLC) is the most aggressive type of lung cancer.

Each year in the U.S., about 30,000 to 35,000 people are diagnosed with it. For most, it has already spread to distant parts of their body by the time they learn they have it.

Although anyone can get SCLC, the major cause of the disease is smoking. It’s rare to get it if you've never smoked.

The number of people who get SCLC has gone down over the last few years as the number of people who smoke has gone down. About 10%-15% of all lung cancers today are SCLC.

This type of lung cancer is less common than non-small-cell lung cancer (NSCLC), which accounts for nearly 85% of all lung cancer cases.

Doctors sometimes call SCLC “oat cell cancer” because the oval-shaped cancer cells look like oat grains under a microscope. Another type of SCLC is called combined small-cell carcinoma. Most SCLCs are the oat cell type.

All cancer risks go up as you age. You’re most likely to get an SCLC diagnosis between the ages of 60-80.

It’s slightly more common in men. But the number of women with SCLC has gone up over the last few decades in the U.S., from 27% of all SCLC cases in 1973 to about 50% of SCLC cases in recent years.

While Blacks and whites have similar rates of lung cancer, black men are less likely than white men to get SCLC. One study showed that Black women are twice as likely as Black men to get a genetic mutation that leads to SCLC.

But it’s smoking that makes the biggest difference in your risk for SCLC. Over 98% of people with the disease have a history of smoking.

Your risk also goes up if you’re exposed to secondhand smoke, radon, asbestos, or you have a family history of SCLC. But none of these raise your risk of SCLC as much as smoking does.

Many people diagnosed with SCLC have a poor prognosis. The disease causes rapid, uncontrolled growth of certain cells in your lungs that eventually form a tumor. The cancer can spread to other areas of the body.

Doctors use 5-year survival rates as a measure to tell you what percentage of people live at least 5 years after diagnosis. The overall 5-year survival rate for people with SCLC is 7%.

But about a fourth of those with limited-stage SCLC (SCLC that’s small and in only one part of your lung) have a good prognosis. Some may even get rid of the cancer completely with early treatments of chemotherapy and radiation therapy.

If you have regional stage SCLC, it means your cancer has spread outside your lung to nearby areas. The 5-year survival rate for this type is 16%.

The distant form, where SCLC has spread to a distant part of your body, is the most deadly. Its 5-year survival rate is only 3%. But nearly 70% of people with SCLC have this form when they’re diagnosed.

Keep in mind that survival rates are affected by many different factors. They’re just general guidelines.

Breakthroughs in early detection and treatment of lung cancer have improved outcomes in the last decade.

But not all racial and socioeconomic groups have seen these benefits. Things that can affect your survival rate include:

Insurance coverage. People with private insurance, managed care plans, and Medicare have better survival rates than those who have Medicaid or who don’t have insurance.

Studies also show that your insurance status can make a difference in the type of treatment you get.

You’re most likely to get no treatment at all if you don’t have insurance. If you have government insurance such as Medicare or Medicaid, you’re more likely to get only chemotherapy. But studies show the most effective treatment is a combination of both chemotherapy and radiation.

Race. Studies show that race may play a part in SCLC survival rate. Both Black and Asian people have better SCLC survival rates than white people.

Income. People with lower incomes tend to have lower survival rates. Researchers tie this information to the fact that they’re less likely to receive medical care.

Those with higher survival rates tend to be people who:

  • Have an annual income of at least $63,000
  • Have private insurance
  • Got an early diagnosis
  • Received treatment at an academic center

Women also have higher survival rates than men.

Studies show your prognosis may be worse if you:

  • Are older than 70
  • Are male
  • Have SCLC that has come back (relapsed SCLC)
  • Have SCLC that has spread into other parts of your body (advanced stage)
  • Have lost more than 10% of your body weight before your diagnosis