Abstract
Introduction
Median age at diagnosis of lung cancer is 70 years. Its presentation in patients 40 or younger is uncommon and it has been proposed that maybe it is a different disease due to its clinical characteristics and genetic makeup. There are a limited number of studies in this population and they report different clinic-pathological characteristics in comparison with older patients.
Methods
We described the incidence of lung cancer patients diagnosed at age 40 or younger at the Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima-Peru; from 2009 to 2017 and evaluated the characteristic of NSCLC. Epidemiologic and clinic-pathological data was collected from clinical files. Analysis was carried out using SPSSvs19 software.
Results
We identified 3823 patients with lung cancer seen at INEN during the study period. Among these, 166 (4.3%) patients were 40 years or younger, and 137/166 (82.5%) were NSCLC. Median age at diagnosis was 36 years (range 14–40 years) and 59.1% of patients were female. A smoking history was present in 14.4% of patients. Frequent symptoms at diagnosis were cough (62.0%), chest pain (51.8%) and dyspnea (40.9%). Adenocarcinoma was the most common histological type (63.3%). Most patients had advanced disease at diagnosis (84.7%). The median overall survival was 8.2 months.
Conclusions
The proportion of young patients with lung cancer in our population is higher than that reported in the most recent literature. Lung cancer in the young is mostly sporadic, more frequent in women, usually adenocarcinoma type and it presents with advanced disease, resulting in a very poor survival.
Similar content being viewed by others
References
Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67:7–30
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386
Cerfolio RJ, Bryant AS (2006) Survival and outcomes of pulmonary resection for non-small cell lung cancer in the elderly: a nested case-control study. Ann Thorac Surg 82:424–430
Thomas A, Chen Y, Yu T, Jakopovic M, Giaccone G (2015) Trends and characteristics of young non-small cell lung cancer patients in the United States. Front Oncol 5:113
Subramanian J, Morgensztern D, Goodgame B, Baggstrom MQ, Gao F, Piccirillo J et al (2010) Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: a surveillance, epidemiology, and end results (SEER) analysis. J Thorac Oncol 5:23–28
Maruyama R, Yoshino I, Yohena T, Uehara T, Kanematsu T, Kitajima M et al (2001) Lung cancer in patients younger than 40 years of age. J Surg Oncol 77:208–212
Li J, Yang F, Li X, Zhang M, Fu R, Yin X et al (2015) Characteristics, survival, and risk factors of Chinese young lung cancer patients: the experience from two institutions. Oncotarget 8:89236–89244
Sacher AG, Dahlberg SE, Heng J, Mach S, Jänne PA, Oxnard GR (2016) Association between younger age and targetable genomic alterations and prognosis in non-small-cell lung cancer. JAMA Oncol 2:313–320
WHO (2015) International classification of diseases for oncology, 3rd edn (ICD-O-3). WHO. World Health Organization. https://www.who.int/classifications/icd/adaptations/oncology/en/. Accessed 15 Jun 2018
Amin MB, Edge SB, American Joint Committee on Cancer. AJCC cancer staging manual. https://www.springer.com/us/book/9783319406176. Accessed 12 Jun 2018
Jemal A, Cokkinides VE, Shafey O, Thun MJ (2003) Lung cancer trends in young adults: an early indicator of progress in tobacco control (United States). Cancer Causes Control 14:579–585. https://doi.org/10.1023/A:1024891201329
Thun MJ, Jemal A (2006) How much of the decrease in cancer death rates in the United States is attributable to reductions in tobacco smoking? Tob Control 15:345–347
Owonikoko TK, Ragin CC, Belani CP, Oton AB, Gooding WE, Taioli E et al (2007) Lung cancer in elderly patients: an analysis of the surveillance, epidemiology, and end results database. J Clin Oncol 25:5570–5577. https://doi.org/10.1200/JCO.2007.12.5435
Cheng T-YD, Cramb SM, Baade PD, Youlden DR, Nwogu C, Reid ME (2016) The international epidemiology of lung cancer: latest trends, disparities, and tumor characteristics. J Thorac Oncol 11:1653–1671
Rich AL, Khakwani A, Free CM, Tata LJ, Stanley RA, Peake MD et al (2015) Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit. QJM 108:891–897. https://doi.org/10.1093/qjmed/hcv052
Vidaurre T, Santos C, Gómez H, Sarria G, Amorin E, López M et al (2017) The implementation of the Plan Esperanza and response to the imPACT Review. Lancet Oncol 18:e595–e606
Nevin PE, Garcia PJ, Blas MM, Rao D, Molina Y (2019) Inequities in cervical cancer care in indigenous Peruvian women. Lancet Glob Health 7:e556–e557
Wang T, Ren H, Li Z, Zhang Z, Sun C, Xu L (1993) Misdiagnosis of lung cancer in patients under age 40—a clinical analysis of 47 cases. Chinese Med Sci J = Chung-kuo i hsueh k’o hsueh tsa chih 8:95–97
Walter FM, Rubin G, Bankhead C, Morris HC, Hall N, Mills K et al (2015) Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer 112:S6–S13
Igata F, Uchino J, Fujita M, Iwasaki A, Watanabe K (2016) Clinical features of lung cancer in japanese patients aged under 50. Asian Pac J Cancer Prev 17:3377–3380
Birring SS, Peake MD (2005) Symptoms and the early diagnosis of lung cancer. Thorax 60:268–269
Lienert T, Serke M, Scho N, Nfeld È, Loddenkemper R (2000) Lung cancer in young females. Eur Respir J 16:986–990
Ruiz R, Galvez Nino M, Roque Perez K, Moreno J, Valdivieso N, Olivera M et al (2019) Epidemiology of advanced lung cancer in Peru. Abstr B 20th World Conference on Lung Cancer. Barcelona, Spain, p 915
Champagne BM, Sebrié EM, Schargrodsky H, Pramparo P, Boissonnet C, Wilson E (2010) Tobacco smoking in seven Latin American cities: the CARMELA study. Tob Control 19:457–462
Morgan BW, Leifheit KM, Romero KM, Gilman RH, Bernabe-Ortiz A, Miranda JJ et al (2017) Low cigarette smoking prevalence in peri-urban Peru: results from a population-based study of tobacco use by self-report and urine cotinine. Tob Induc Dis. 15:32
Shen H, Tao S, Liu J, Huang Y, Chen H, Li W et al (2015) Global lung cancer risk from PAH exposure highly depends on emission sources and individual susceptibility. Sci Rep 4:6561
Dilger M, Orasche J, Zimmermann R, Paur H-R, Diabaté S, Weiss C (2016) Toxicity of wood smoke particles in human A549 lung epithelial cells: the role of PAHs, soot and zinc. Arch Toxicol 90:3029–3044
Raspanti GA, Hashibe M, Siwakoti B, Wei M, Thakur BK, Pun CB et al (2016) Household air pollution and lung cancer risk among never-smokers in Nepal. Environ Res 147:141–145
Sun S, Schiller JH, Gazdar AF (2007) Lung cancer in never smokers—a different disease. Nat Rev Cancer 7:778–790
Korpanty GJ, Kamel-Reid S, Pintilie M, Hwang DM, Zer A, Liu G et al (2018) Lung cancer in never smokers from the Princess Margaret Cancer Centre. Oncotarget 9:22559–22570
Pan X, Lv T, Zhang F, Fan H, Liu H, Song Y (2018) Frequent genomic alterations and better prognosis among young patients with non-small-cell lung cancer aged 40 years or younger. Clin Transl Oncol 20:1168–1174
Mas L, Piscocha C, Landa J, Roe C, Roe E, Barletta C (2017) Prevalence of EGFR mutations in the Peruvian population: study in a large cohort of patients with NSCLC. J Clin Oncol. https://doi.org/10.1200/JCO.2017.35.15_suppl.e13076
Mas L, de la Torre J, Páginas CB-E, 2011 undefined. Estado mutacional de los exones 19 y 21 de EGFR en adenocarcinoma de pulmón: Estudio en 122 pacientes peruanos y revisión de la evidencia de eficacia. cdn2.hubspot.net. https://cdn2.hubspot.net/hubfs/2202832/produccion-cientifica/revista-carcinos-volumen-1-numero-2.pdf#page=16. Accessed 15 Jun 2018
Pinto JA, Mas LA, Gomez HL (2017) High epidermal growth factor receptor mutation rates in Peruvian patients with non-small-cell lung cancer: is it a matter of asian ancestry? J Glob Oncol 3:429–430. https://doi.org/10.1200/JGO.2016.008201
Jin X, Wu X, Roth JA, Amos CI, King TM, Branch C et al (1995) Higher lung cancer risk for younger African-Americans with the Pro/Pro p53 genotype. Carcinogenesis 16:2205–2208. https://doi.org/10.1093/carcin/16.9.2205
Brennan P, Hainaut P, Boffetta P (2011) Genetics of lung-cancer susceptibility. Lancet Oncol 12:399–408
Jonsson S, Thorsteinsdottir U, Gudbjartsson DF, Jonsson HH, Kristjansson K, Arnason S et al (2004) Familial risk of lung carcinoma in the icelandic population. JAMA 292:2977
Zhang Y, Shu X-O, Gao Y-T, Ji B-T, Yang G, Li HL et al (2007) Family history of cancer and risk of lung cancer among nonsmoking Chinese women. Cancer Epidemiol Biomarkers Prev 16:2432–2435
Bryant AS, Cerfolio RJ (2008) Differences in outcomes between younger and older patients with non-small cell lung cancer. Ann Thorac Surg 85:1735–1739
Arnold BN, Thomas DC, Rosen JE, Salazar MC, Blasberg JD, Boffa DJ et al (2016) Lung cancer in the very young: treatment and survival in the national cancer data base. J Thorac Oncol 11:1121–1131
Jiang W, Kang Y, Shi G-Y, Zhang H-Y, Cai L, Sun X-W et al (2012) Comparisons of multiple characteristics between young and old lung cancer patients. Chin Med J (Engl) 125:72–80
Cherny NI, Sullivan R, Torode J, Saar M, Eniu A (2017) ESMO International Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in countries outside of Europe. Ann Oncol 28:2633–2647
Funding
This study was not funded.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Galvez-Nino, M., Ruiz, R., Pinto, J.A. et al. Lung Cancer in the Young. Lung 198, 195–200 (2020). https://doi.org/10.1007/s00408-019-00294-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00408-019-00294-5