title: Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: a surveillance, epidemiology, and end results (SEER) analysis.
abstract: BACKGROUND
  The median age of patients with newly diagnosed non-small cell lung cancer (NSCLC) at presentation is 71 years. We conducted an analysis of Surveillance, Epidemiology, and End Results data to assess whether the presentation and outcomes of NSCLC in younger patients (age < or =40 years) are different from that in older patients (age >40 years).
  
  
  METHODS
  We obtained the demographic, clinical, and outcomes data for all patients diagnosed with NSCLC from 1988 to 2003 in the Surveillance, Epidemiology, and End Results registry. Patients were grouped by age at diagnosis into younger than or equal to 40 years (younger cohort) or older than 40 years (older cohort).
  
  
  RESULTS
  During the period analyzed, we identified 2775 patients with NSCLC in the younger cohort and 236,313 patients in the older cohort. Compared with the older group, the younger group had greater proportion of African Americans (19.2% versus 10.9%; p < 0.0001), Asian or Pacific Islander (10.3% versus 5.9%; p < 0.0001), women (48.7% versus 41.9%; p < 0.0001), and patients with stage IV disease (57.4% versus 43.0%; p < 0.0001). Adenocarcinoma was more common in younger patients than in the older patients (57.5% versus 45.2%; p < 0.0001). Squamous cell carcinoma was less prevalent in the younger cohort than in older cohort (12.5% versus 26.4%; p < 0.0001). Five-year overall survival and cancer specific survival were significantly better for younger patients than for older patients across all stages.
  
  
  CONCLUSIONS
  There is a greater representation of African Americans, Asians or Pacific Islanders, women, and adenocarcinoma histology in the younger cohort of patients with NSCLC compared with the older cohort. Despite presenting with stage IV disease more often, the overall and cancer-specific survivals are better in younger cohort than in the older cohort.
authors.affiliation: Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Janakiraman
authors.initials: J
authors.lastname: Subramanian
authors.forename: Daniel
authors.initials: D
authors.lastname: Morgensztern
authors.forename: Boone
authors.initials: B
authors.lastname: Goodgame
authors.forename: Maria Q
authors.initials: MQ
authors.lastname: Baggstrom
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Jay
authors.initials: J
authors.lastname: Piccirillo
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Govindan
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000556:secondary / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000453:epidemiology* / Q000556:secondary / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000556:secondary / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult