Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit.
BACKGROUND
Non-small cell lung cancer (NSCLC) in young adults is a rare but devastating illness with significant socioeconomic implications, and studies of this patient subgroup are limited.


OBJECTIVE
This study employed the National Lung Cancer Audit to compare the clinical features and survival of young adults with NSCLC with the older age groups.


METHODS
A retrospective cohort review using a validated national audit dataset.


METHODS
Data were analysed for the period between 1 January 2004 and 31 December 2011. Young adults were defined as between 18 and 39 years, and all others were divided into decade age groups, up to the 80 years and above group. We performed logistic and Cox regression analyses to assess clinical outcomes.


RESULTS
Of a total of 1 46 422 patients, 651 (0.5%) were young adults, of whom a higher proportion had adenocarcinoma (48%) than in any other age group. Stage distribution of NSCLC was similar across the age groups and 71% of young patients had stage IIIb/IV. Performance status (PS) was 0-1 for 85%. Young adults were more likely to have surgery and chemotherapy compared with the older age groups and had better overall and post-operative survival. The proportion with adenocarcinoma, better PS and that receiving surgery or chemotherapy diminished progressively with advancing decade age groups.


CONCLUSIONS
In our cohort of young adults with NSCLC, the majority had good PS despite the same late-stage disease as older patients. They were more likely to have treatment and survive longer than older patients.
From the Nottingham University Hospitals and anna.rich@nottingham.ac.uk.
A L
AL
Rich
Epidemiology and Public Health, Clinical Sciences Building, City Campus, Hucknall Road, Nottingham NG5 1PB, UK.
A
A
Khakwani
University Hospitals of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK and.
C M
CM
Free
Epidemiology and Public Health, Clinical Sciences Building, City Campus, Hucknall Road, Nottingham NG5 1PB, UK.
L J
LJ
Tata
Health and Social Care Information Centre (HSCIC), 1, Trevelyan Square, Leeds LS1 6AE, UK.
R A
RA
Stanley
Health and Social Care Information Centre (HSCIC), 1, Trevelyan Square, Leeds LS1 6AE, UK.
M D
MD
Peake
Epidemiology and Public Health, Clinical Sciences Building, City Campus, Hucknall Road, Nottingham NG5 1PB, UK.
R B
RB
Hubbard
From the Nottingham University Hospitals and.
D R
DR
Baldwin
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D004739:England / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016019:Survival Analysis; D055815:Young Adult