Lung cancer is the most common cancer in the world today, and the prognosis for lung cancer patients is poor. In the Nordic countries, the five-year relative survival was only seven percent in patients diagnosed in 1983-87. In the present study, the survival of 36,010 lung cancer patients diagnosed in Norway in 1954-93 was examined, based on data from the population-based Cancer Registry of Norway. The variation in survival by gender, age, stage, period of diagnosis, and histologic group was explored. Relative survival rates were calculated and relative risks of dying were obtained from multivariate Cox proportional hazards regression analysis. Only a slight improvement in the prognosis of lung cancer patients was observed during the 40-year study period. More than half the patients died during the first six months after diagnosis. Patients with small cell carcinoma had the lowest frequency of localized tumors and also had the poorest prognosis, even after adjustment for stage. Patients with squamous cell carcinoma had the highest frequency of localized tumors. The patients with a localized tumor also have a poor prognosis, with a crude median survival time of nine months in males and 11 months in females in 1984-93.