Small cell lung cancer in young patients: trends in sociodemographic factors, diagnosis, treatment, and survival

Abstract

Background: Small cell lung cancer (SCLC) in patients <50 years old has unique socioeconomic and clinical implications. We aimed to examine the demographics, treatment patterns, and survival of young patients with SCLC and compared them to older adults. Methods:The National Cancer Database (NCDB) was queried to identify SCLC cases diagnosed from 2004 to 2016. Patients were divided into three age groups: 18-50, 50-70, and ≥70 years. Patient characteristics were evaluated for survival within each age group. Kaplan-Meier and Cox regression analyses were used to assess survival.Results: Of the 172,453 evaluated SCLC patients (median age 66 years), 8,792 were 18-50 years old.Compared to the older groups, patients under 50 were more likely to be Black, uninsured or on Medicaid, have household income <$30,000, and present with stage III or IV disease (P<0.0001 for all). While young patients were more likely to receive guideline-concordant care (GCC), the hazard of death increased to 1.96 (95% CI: 1.80-2.14; P<0.0001) with receipt of nonstandard therapy. Private insurance, female gender, non-White race, Hispanic ethnicity, and higher income were associated with better survival. The youngest cohort had significantly better survival overall when compared to the older patients (P<0.0001), but the survival advantage was reduced with the advancing stage.Conclusions: SCLC patients under 50 years old represent a socioeconomically disadvantaged group with advanced disease at presentation. Despite having fewer comorbidities and being offered guideline-concordant treatment, younger patients with SCLC have only marginally better survival than older patients in advanced stages.

Aspectos epidemiológicos do Câncer de Pulmão na Amazônia Paraense

“…Em contrapartida, ainda nos Estados Unidos, evidencia-se maior proporção do câncer em estudo na população feminina (Lee et al, 2022). Mesmo com taxas mais baixas de uso de tabaco, mulheres que fumam têm maior probabilidade de desenvolver câncer de pulmão do que os homens, já sendo observada ascendência de casos em mulheres (Erefai et al, 2022).…”

“…Em relação à raça/cor, mais da metade dos indivíduos diagnosticados com câncer de pulmão se autodeclarou parda. Isso foi semelhante aos resultados de outros estudos na literatura (Lee et al, 2022;Annangi et al, 2019). Acredita-se que o status socioeconômico mais baixo possa explicar parcialmente as proporções mais altas observadas aqui, uma vez que a condição socioeconômica está associada à exposição a fatores de risco e as populações pardas apresentam maior exposição a riscos ocupacionais, fumo passivo e à redução da capacidade de conscientização, teste e correção de radônio (Juon et al, 2021;Yang et al, 2022).…”

Prognosis of early‐stage lung adenocarcinoma in young patients

“…Several studies 2,17–21,27 have revealed that young age is tied to genomic mutations, such as epidermal growth factor receptor, anaplastic lymphoma kinase and receptor tyrosine kinase 1 (EGFR, ALK and ROS1, respectively) in LUAD. Oxnard and his colleagues 2 systematically examined the combination between younger age and targetable genomic alterations and illustrated that patients <50 years of age had a 59% higher ratio of harbouring a targetable genotype.…”

Prognostic value of pretreatment serum fibrinogen in young patients with small cell lung cancer: A cross‐sectional study

“…SCLC in young patients has unique socioeconomic and clinical implications 9 . Very few studies have described SCLC in young (<50 years old) patients 9,10 . The study aims to explore the impact of baseline serum fibrinogen on clinical outcome in young patients with SCLC.…”

“… 9 Very few studies have described SCLC in young (<50 years old) patients. 9 , 10 The study aims to explore the impact of baseline serum fibrinogen on clinical outcome in young patients with SCLC. We hypothesize that pretreatment serum fibrinogen concentration is related to overall survival (OS) of young patients with SCLC.…”