OBJECTIVES: To investigate the self-reported burden imposed by care of lung cancer (LC) patients in the European Union (EU).  METHODS: The study included respondents to the 2010 and 2011 EU National Health and Wellness Survey from France, Germany, Italy, Spain, and the United Kingdom who reported being caregivers for a relative with LC versus respondents who did not report being caregivers for a relative with any condition (control). Outcome measures included Short Form (SF)-6D health state utilities and mental and physical health status (all derived from the SF-12v2), stress-related comorbidities, healthcare resource use during the past 6 months, and work/activity impairment during the past week using the Work Productivity and Activity Impairment (WPAI) questionnaire. Productivity losses were converted into costs using the human capital method by applying median hourly wages per country (from Eurostat 2006 personal income inflated to 2010) to the total number of hours lost using results from WPAI. Multivariable analyses were used to test the potential impact of LC patient caregiving on healthcare resource use and work/activity impairment, as well as costs specifically associated with work impairment. RESULTS: 107 caregivers for patients with LC and 103,868 non-caregivers were identified. Compared with non-caregivers and adjusting for covariates, caregivers had higher mean levels of impaired presenteeism (27.1% vs. 14.8%), overall work impairment (32.4% vs. 18.0%), and activity impairment (32.8% vs. 21.8%; all p<0.005); higher odds of impact across all measures of the WPAI including absenteeism (all p<0.01); and higher annual costs associated with impaired presenteeism (€5,672 vs. €3,429) and overall work impairment (€6,905 vs. €4,147; both p<0.05). Healthcare resource utilization and mean level of absenteeism did not differ significantly. CONCLUSIONS: LC patient caregiving in the EU is associated with significantly higher work/activity impairment and related costs relative to non-caregivers. Costs associated with LC caregiver burden deserve further attention.