Trend of non-small cell lung cancer in young people.

Abstract

e20509 Background: Non-small cell lung cancer (NSCLC) in young individuals is a rising concern, challenging the traditional understanding of the disease. While NSCLC is typically associated with older populations, the increasing cases among younger people suggest the existence of unique and intriguing risk factors and clinical characteristics. This study aims to investigate the trend and risk factors of NSCLC in young people aged 18-55. Methods: We retrospectively analyzed a total of 218 patients aged 18 to 55 diagnosed with NSCLC from 2016 to 2023 using Electronic Medical Records. 126 patients met the inclusion criteria, and 92 patients were excluded due to inaccurate diagnosis codes and erroneous records. These patients were divided into two groups based on the year of diagnosis: 2016-2018 and 2019-2023. We included baseline patient characteristics like demographic data, epidemiological and individual risk factors like immunosuppression, occupational and radiation exposure, family history of cancer, hormonal therapy, and history of hysterectomy and analyzed the association with the incidence of NSCLC. Results: Of the 126 patients in our study, a significant (96.0%) were young adults aged 41 to 55. The median age of our patients was 52. Most were diagnosed between 2019-2023 (78.6%) compared to 2014-2018 (21.4%). At the time of diagnosis, (61.9%) had stage IV disease compared to (15.9%) who had stage I. Adenocarcinoma was the most common histology (80.2%), followed by squamous (11.1%). In our study, (56.3%) of patients had a positive family history of cancer. A high proportion had a history of smoking (76.9%) with a median pack year history of 20 with a range of 0 to 70 pack years. More females (52.5%) had a history of smoking (current or former) compared to males (47.4%), and more females (55.1%) had stage IV disease at the time of diagnosis compared to males (44.9%). Among those with no history of smoking, (62.1%) were females compared to males (37.9%), and more females (62.5%) had stage IV disease at the time of diagnosis vs males (37.5%). Regarding race, most of our patients were white/Caucasian (80.2%), and the most minor proportion of the patients belonged to Hispanic or Chinese race (0.8%). Our study found that PDL1 (15.1%) was the most common expression in NSCLC in patients aged 18-55. EGFR (11.9%), KRAS (11.1%), ROS (2.4%), and ALK (1.9%) were next. In our study, we found that radiation and occupational exposure, immunosuppression, hormonal therapy, and hysterectomy did not increase the risk of NSCLC. Conclusions: We found that females had a higher tendency to be diagnosed with later-stage disease regardless of their smoking history, and smoking and a family history of cancer are risk factors for NSCLC in young people. Additionally, PDL-1 was the most common expression found in young people diagnosed with NSCLC, this finding has the potential to influence treatment strategies.