Distinctive Characteristics of Non-small Cell Lung Cancer (NSCLC) in the Young: A Surveillance, Epidemiology, and End Results (SEER) Analysis

Abstract

There is a greater representation of African Americans, Asians or Pacific Islanders, women, and adenocarcinoma histology in the younger cohort of patients with NSCLC compared with the older cohort. Despite presenting with stage IV disease more often, the overall and cancer-specific survivals are better in younger cohort than in the older cohort.

Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): A California Cancer Registry analysis

“…In a SEER analysis, five-year overall survival was significantly better in a group younger than 50 years of age (16.1% vs. 13.4%; P < .001), principally as a result of better survival in patients with presumably curable (localized or early stage) disease (48.7% vs. 35.4%; P < .001) [7]. Furthermore, these investigators reported that male sex was also an independent negative prognostic factor.…”

“…There are several possible explanations for this emerging observation. Young patients tend to receive more aggressive treatment than their older counterparts, which could have translated into better outcomes [3,7]. There may also have been a higher rate of actionable mutations within the tumors of younger patients for which effective targeted therapy drugs are available.…”

“…There have been numerous papers focused on young NSCLC patients, each with varying definitions of "young" [5][6][7][8]. Some of these studies attempted to compare outcomes between younger and older NSCLC patients.…”

“…Some community-based and national registry analyses of all forms of bronchogenic carcinoma have found improved outcomes in younger cohorts [18,19]. A more recent surveillance, epidemiology, and end results (SEER) study of NSCLC patients <40 years of age concluded that "despite presenting with stage IV disease more often, the overall and cancer-specific survivals are better in (the) younger than in the older cohort" [7]. Many of these prior studies attempted to define clinical characteristics predictive of outcome for young NSCLC patients.…”

Metastatic Adenocarcinoma in the Young Adult

“…The incidence of lung cancer among young adults has been found to be around 1.2% to 6.2% (under 40 years), 5.3% (under than 45 years) [1][2][3][4], and 13.4% (under 50 years) [5]. However, previous reports have shown trends of increasing incidence rates of lung cancer among young patients [6,7].…”