Lung Cancer Trends Shift Younger in Indonesia Amid Screening Hurdles
JAKARTA – Indonesia is facing a worrying shift in its oncological landscape as health experts report a rise in cases among younger demographics. The Indonesian Respiratory Doctor Association (PDPI) recently disclosed that lung cancer, once considered a disease of the elderly, is now increasingly affecting individuals as young as 20.
The average age of diagnosis in the country has dropped to approximately 40 years old—a notable departure from the global benchmark of 45 years established by the World Health Organization (WHO).
"There are even individuals just 20 years old who have been diagnosed with lung cancer," said Erlang Samudro, Head of the Thoracic Oncology Working Group at PDPI, during a media briefing on August 18, 2026.
The Screening Gap
While early detection is the cornerstone of effective cancer treatment, PDPI notes that Indonesia’s screening infrastructure remains suboptimal. Experts advocate for a risk-stratified approach using low-dose computed tomography (LDCT) scans. Unlike standard imaging, LDCT is capable of detecting minor pulmonary nodules, which allows for potentially life-saving surgical interventions.
However, access to this technology is severely constrained. LDCT machines are largely centralized in major urban hubs, leaving patients in remote regions without the means to undergo proper screening. Furthermore, the financial burden of implementing mass LDCT screenings poses a significant challenge to the national healthcare budget.
Currently, the government’s Free Health Check (CKG) program relies heavily on chest X-rays. While accessible, Erlang warned that X-rays are insufficient for definitive lung cancer detection. "We may miss crucial indicators because certain locations cannot be detected, such as areas behind the heart or those obscured by the scapula," he explained.
A Culture of Late Diagnosis
The consequences of limited screening and diagnostic tools are stark. PDPI estimates that between 70% and 80% of Indonesian lung cancer patients are not diagnosed until they have reached stage III or IV.
"Catching cancer at an early stage enables eligible patients to undergo surgery or definitive radiotherapy," Erlang said. "When we detect it late, we are forced to rely on systemic therapies, which significantly lowers the chances for a curative outcome."
Beyond infrastructure, medical professionals are battling a complex web of social and clinical barriers. Atypical symptoms—such as chronic coughing and shortness of breath—are frequently misidentified as tuberculosis (TB) or chronic obstructive pulmonary disease (COPD), delaying specialized care. Additionally, social stigma surrounding smoking and a fear of diagnosis often deter symptomatic patients from seeking timely testing.
A Growing National Crisis
The statistics underscore the severity of the situation. Data from the International Agency for Research on Cancer (IARC) via the Global Cancer Observatory (GLOBOCAN) reveals that lung cancer is responsible for 18.7% of all cancer-related deaths worldwide.
In Indonesia, it ranks as the second most prevalent cancer, with approximately 38,900 new cases emerging every year. PDPI President Arif Riadi Arifin described the situation as a "major clinical challenge" driven primarily by the high rate of late-stage diagnosis.
For PDPI, the path forward requires more than just new equipment; it demands a robust regulatory framework that mandates standardized screening protocols and improved access to thoracic radiology and pathology services. Without these systemic changes, the association warns that the national burden of the disease will only continue to grow.
