Abstract
Lung cancer epidemiology varies widely across countries, yet local data remain scarce. This study analyzed 882 lung cancer cases registered in the Addis Ababa population-based cancer registry from 2012 to 2023 to characterize patient profiles, incidence rates, and trends. We used descriptive statistics, binary and multinomial logistic regression, Poisson regression, and joinpoint regression. We found the crude median age at diagnosis was 56 years (adjusted: 60 years), with one in four patients diagnosed before 45. Adenocarcinoma was the most common histological subtype (34.8%), significantly associated with females (AOR: 1.64, 95% CI: 1.21–2.21), followed by squamous cell carcinoma (8.8%). Carcinoma not otherwise specified (NOS) accounted for 45.2% of cases. Alarmingly, 93% of patients were diagnosed at a late stage. The age-standardized incidence rate (ASIR) was 3.1 per 100,000 (3.3 for males, 2.8 for females), with a male-to-female incidence rate ratio (IRR) of 1.13, showing a nonsignificant decline over time. The incidence rate increased with age and varied significantly across sub-cities (1.5–2.9 per 100,000). While the overall ASIR trend remained stable, sex-specific trends showed a 3% annual increase in female crude incidence rates, whereas male rates remained unchanged significantly. These findings highlight the urgent need for targeted lung cancer prevention, early detection, and treatment strategies tailored to local epidemiological patterns. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-36944-x.