This guideline covers diagnosing and managing non-small-cell and small-cell lung cancer. It aims to improve outcomes for patients by ensuring that the most effective tests and treatments are used, and that people have access to suitable palliative care and follow-up.

 A table of NHS England interim treatment regimens gives possible alternative treatment options for use during the COVID-19 pandemic to reduce infection risk. This may affect decisions for patients with lung cancer. See the COVID-19 rapid guideline: delivery of systemic anticancer treatments for more details.


In March 2019, we reviewed the evidence and made new recommendations on:

These supplement the existing recommendations on diagnosistreatment for non-small-cell and small-cell lung cancer and palliative care.

NICE has also produced visual summaries on:

systemic treatment options for advanced squamous NSCLC intrathoracic staging before radical treatment
View visual summary
View visual summary
systemic treatment options for advanced non-squamous NSCLC: EGFR-TK, ALK or ROS-1 positive
systemic treatment options for advanced non-squamous NSCLC: no gene mutation or fusion protein
View visual summary
View visual summary

Who is it for?

  • Healthcare professionals
  • Commissioners and providers
  • People with lung cancer and their families and carers

Is this guideline up to date?

We checked this guideline in September 2021 to assess if it should be highlighted as a HIV indicator condition. We did not have clinical consensus, so will not amend it but will note the issue for consideration in the future.

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE guideline CG121 (April 2011).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)