INTRODUCTION: We examined the recent changes in stage distribution in newly diagnosed patients with non-small cell lung cancer (NSCLC) using a national database to assess the impact of recent advances in imaging modalities. METHODS: We searched the National Cancer Database for patients with NSCLC diagnosed between the calendar years 1998 and 2006 for which staging information was available. RESULTS: Among the 877,518 patients diagnosed with NSCLC during the study period, staging information was available for 813,302 patients (92.6%). We observed a change in stage distribution between the years 2000 and 2001, with a decrease in stage I, from 27.5 to 24.8%, and a corresponding increase in stage IV, from 35.4 to 38.8%. No significant changes in stage distribution were noted after 2002. CONCLUSION: Our study showed a recent and significant stage migration in patients with NSCLC. It is likely that increased acceptance and widespread use of 18fluorodeoxyglucose-positron emission tomography scan and routine brain imaging could account for these changes.