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Young adults with NSCLC more likely to receive advanced disease diagnosis

Vienna – Young people (under 50) with non-small cell lung cancer (NSCLC) are diagnosed with advanced disease compared with older adults, a researcher says here is much more likely.

In 2018, 5 years after the U.S. Preventive Services Task Force recommended low-dose CT lung cancer screening (LCS) for people over 55 years of age – down to 50 in 2021 Age Over – There are some 79 year old patients were diagnosed with an absolute difference of 21%.

This absolute difference is much larger than the 13% difference observed in 2010, when 60% of younger patients were diagnosed with IV stage disease, compared with 47% in older patients, he gave a presentation at the World Conference on Lung Cancer (WCLC).

“Different tumor biology, delays in diagnosis, and lack of promotion of early detection of lung cancer in young adults may be responsible for high rates of diagnosis of stage IV disease,” Yang said in a WCLC news release. Why.

However, WCLC discussant Anand Devaraj, MD, Royal Brompton Hospital, Imperial College London, cautions that “it is impossible to determine whether this phase shift is directly attributable to screening. – There may be other factors involved.

In 2021, the Task Force revised the LCS recommendations for people 50-80 years of age with a 20-pack-year smoking history who either currently smoke or have quit within the past 15 years. The recommendation also states that, “Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that severely limits life expectancy or the ability or willingness to undergo curative lung surgery. “

” This data [from Yang’s group] got me thinking about the challenges we all face… it’s how to identify high-risk engagement in groups that don’t have easy access not just younger patients, but also older patients who do not have adequate risk factors based on current risk models,” Devaraj said.

Yang and colleagues used surveillance epidemiological final results (SEER) database and the National Cancer Database to identify patients, aged 20-79, diagnosed with non-small cell lung cancer from 2010-2018. During this period, 1,038, 5,682, and 39,323 20-29, 30-39 and 40-49 year olds were diagnosed with NSCLC.

The authors observed that with age, the proportion of patients diagnosed with stage I NSCLC increased over time , while the proportion of patients diagnosed with stage IV cancer declined. Specifically, they found that among younger adults, 8% of patients (ages 20-29) were diagnosed with stage I disease, while 76% were diagnosed with stage IV disease Disease. The percentage of patients diagnosed with stage I disease in the 30-39 and 40-49 age groups increased slightly to 10% and 14%, respectively, while the percentage of patients diagnosed with stage IV disease in these age groups decreased, but still in as high as 70% and 60%, respectively.

In contrast, 29% of patients (70-79 years) were diagnosed with stage I disease and 40% were diagnosed with stage IV disease disease.

Yang and colleagues also looked at survival data and found that while early diagnosis in young adults did not improve, median overall survival (OS) in young adults diagnosed with NSCLC ) did increase by 14 months from 2010 to 2018, mainly due to improved survival in patients with advanced disease.

“It is worth noting that these The improvement appears to be comparable to the NCCN [National Comprehensive Cancer Network] 2012 gene detection for EGFR and ALK mutated genes recommended, and as an immunotherapy by the FDA in 2015,” Yang said.

However, Yang and colleagues found that the youngest patients (20-29 years old) diagnosed with NSCLC had The lowest 5-year OS rate was 20%, 24% in elderly patients (70-79 years), and 28% in middle-aged patients (40-49 years). In addition, the 5-year OS rate for patients diagnosed with stage IV disease was OS was particularly low in all younger age groups (11%, 15% and 10% of patients in the 20-29, 30-39 and 40-49 age groups,

Study limitations included the fact that it did not include data on disease-free or relapse-free survival, tumor biomarkers, use of targeted therapy, or time to clinic visit

Yang noted , “The improvement in median survival observed in young adults diagnosed with lung cancer is encouraging,” but his team emphasizes that strategies to increase early detection of lung cancer in young patients who are often ineligible for LCS are “urgently needed.” of”.

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    Mike Bassett is a staff writer specializing in oncology and hematology. He lives in Massachusetts.

    Disclosure

    Yang Disclosure has no affiliation with the industry.

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