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Objective: Treatment options for non‐small‐cell lung cancer (NSCLC) have been evolving. The goal of our study was to evaluate whether novel therapeutics are used in the elderly population and improve outcomes to a similar extent as in young patients. Methods: We enrolled patients registered in the Cancer Registry of Eastern Switzerland and grouped them into four cohorts: Elderly patients aged ≥70 years diagnosed 2005–2007 and 2015–2016 (elderly cohorts 1,2) were compared to cohorts of patients < 70 years diagnosed during the same time periods (young cohorts 1,2). Results: 499 individuals were analysed. Median cancer‐specific survival in the elderly cohorts 1 and 2 was 3.9 months and 6.3 months, respectively, and 8.0 and 12.7 months in the young cohorts 1 and 2. 12‐month survival significantly improved over ten years only in younger patients (35.6% and 54.9%), however not in the elderly cohorts (20% vs. 35%). Proportion of patients receiving any line of systemic treatment remained lower in the elderly cohorts (53% vs. 78%). Conclusion: Despite the increase in median cancer‐specific survival in both cohorts, a significant and clinically meaningful improvement of 12‐month cancer‐specific survival was only seen in young patients. The adoption of novel treatment approaches is lagging behind in the elderly population. [ABSTRACT FROM AUTHOR]