Trends and Characteristics of Young Non-Small Cell Lung Cancer Patients in the United States

Abstract

BackgroundAlthough the median age at diagnosis of non-small cell lung cancer (NSCLC) is 70 years, a subset of patients with NSCLC present at a younger age (<40 years). Little is known about the time-trends in incidence of NSCLC in the young, their characteristics and outcomes.MethodsThe surveillance, epidemiology, and end results database was used to extract NSCLC cases from 1978 to 2010. Yearly incidence rates in various age groups, race, site of disease, histology, treatment patterns, and outcomes were assessed. We modeled Kaplan–Meyer survival curves stratified by age of presentation.ResultsYoung patients represented 0.6% of incident NSCLC from 1978 to 2010. The incidence of young NSCLC declined significantly during this time-period. Young NSCLCs had a higher proportion of women (51%), Asians or Pacific Islanders (14%), adenocarcinoma histology (59%) and were more likely to present with distant metastases (68%). The young had better all cause and lung cancer-specific survival than the older patients (median survival for localized, regional, and distant disease: not reached, 28, 9 vs. 46, 17, 5 months; p < 0.001 for all groups). Male sex, non-adenocarcinoma histology, and main bronchial primary were independent negative prognostic factors among the young. In contrast to the overall population, black race was a poor prognostic factor among the young.ConclusionThe incidence of NSCLC in the young decreased from 1978 to 2010. The clinical characteristics of NSCLC in the young, including demographic distribution, treatment, and outcomes are different from those observed in the older patients.

Survival improvement in patients with non–small cell lung cancer between 1983 and 2012: Analysis of the Surveillance, Epidemiology, and End Results database

“…3,4 Although previous studies have investigated NSCLC outcomes, they tended to evaluate subgroups of patients, such as patients from specific regions, of specific ages, or who underwent surgery, or to focus on the effects of specific histological type or stage on survival. [5][6][7][8][9][10][11] In addition, accumulating evidence of significant racial and socioeconomic status (SES) disparities in the U.S. health care system has been attracting increased attention. We used period analysis in this study to demonstrate the shift in survival time in each decade between 1983 and 2012 and to determine the impacts of race, sex, age, and SES on the survival rates in patients with NSCLC, using data from the SEER program of the National Cancer Institute.…”

Monocytic myeloid-derived suppressor cells as a potent suppressor of tumor immunity in non-small cell lung cancer

“…Non-small cell lung cancer (NSCLC) accounts for >85% of all cases of lung cancer. NSCLC is primarily treated by surgery (2), however, patients diagnosed in the advanced stages of the disease often may not qualify for surgery. In such cases, immunotherapy may be a promising therapeutic strategy.…”

Characteristics of Lung Cancer in Patients Younger than 40 Years: A Prospective Multicenter Analysis in France

“…Some studies concluded that young patients had a longer survival [10,12,13,[15][16][17][18], although the authors sometimes acknowledged that they received more aggressive treatment, others found a shorter survival [19], and many studies did not find any survival difference between young and older patients [9,14,[21][22][23][24]. However, these results cannot be compared because the cut-off used to define young patients varies from 40 to 50 years, and the populations included in these studies are heterogeneous, sometimes limited to non-small cell lung cancer (NSCLC) or adenocarcinoma or restricted to patients who underwent surgery.…”