Sumiya Ryusuke, Matsunaga Takeshi, Suzuki Kenji
Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2025 Mar 31;17(3):1746-1754. doi: 10.21037/jtd-2024-1950. Epub 2025 Mar 21.
Lung cancer remains a leading cause of cancer-related deaths globally, with an estimated 2.5 million new patients and 1.8 million deaths in 2022. While lung cancer predominantly affects older individuals, there is growing concern about the impact of lung cancer on younger generations, specifically adolescents and young adults (AYA) patients aged 15-39 years. Lung cancer in young individuals has several unique characteristics, such as sex preference, histological subtype, and frequency of somatic mutations in , , and . In this article, we describe the risk factors for young patients with lung cancer in two aspects: internal and external predispositions. Although many researchers have focused on genetic predispositions, such as germline genetic alterations, genetic predispositions cannot fully explain the development of lung cancer in young patients. Therefore, we focused on external factors, such as viral infections. Younger patients generally have a better prognosis than older patients, and there is minimal difference in survival rates among advanced-stage young and older patients, which indicates the importance of early detection and intervention, regardless of age. The younger generation has fewer opportunities for radiography or computed tomography, and accidental detection during the examination of other diseases is extremely valuable and effective. Awareness-building activities for pediatricians and other specialists, such as general internal medicine specialists, are important for improving the outcomes of young patients with lung cancer.
肺癌仍然是全球癌症相关死亡的主要原因，2022年估计有250万新发病例和180万死亡病例。虽然肺癌主要影响老年人，但人们越来越关注肺癌对年轻一代的影响，特别是15至39岁的青少年和青年（AYA）患者。年轻个体的肺癌具有几个独特特征，如性别偏好、组织学亚型以及在……中的体细胞突变频率。在本文中，我们从内部和外部易感性两个方面描述年轻肺癌患者的危险因素。尽管许多研究人员专注于遗传易感性，如种系基因改变，但遗传易感性并不能完全解释年轻患者肺癌的发生。因此，我们关注外部因素，如病毒感染。年轻患者的总体预后通常比老年患者好，晚期年轻和老年患者的生存率差异极小，这表明无论年龄大小，早期检测和干预都很重要。年轻一代进行X线摄影或计算机断层扫描的机会较少，在检查其他疾病时偶然发现极为宝贵且有效。提高儿科医生和其他专科医生（如普通内科专科医生）的认识对于改善年轻肺癌患者的治疗效果很重要。
