Florez Narjust, Kiel Lauren, Kaufman Rebekah, LoPiccolo Jaclyn, Ricciuti Biagio, Morabito Angela, Fakorede Olayinka, Mantz Courtney, Olazagasti Coral, Swami Nishwant, Kanan Duaa, Alder Laura, Sridhar Arthi, Bergerot Cristiane Decat, Bye Bianca, Velazquez Ana I, Shaw Alice T
Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Oncol. 2025 Jun 26;15:1570143. doi: 10.3389/fonc.2025.1570143. eCollection 2025.
Young patients with lung cancer represent a distinct population, with unique disease and treatment-related characteristics, as well as psychosocial and survivorship needs. Nevertheless, this population remains vastly understudied.
We review the unique clinicopathological characteristics and needs of young patients with lung cancer, including topics such as incidence rates, diagnostic challenges, genomics, treatment patterns and outcomes, psychosocial needs, fertility and sexual health, and palliative care. We discuss emerging and understudied data, provide recommendations on aspects in which future research is warranted, and advocate for actionable strategies that multi-disciplinary healthcare teams may adopt to provide more personalized and equitable care.
Though epidemiological trends suggest an overall decrease in lung cancer incidence among all age groups, recent increasing incidences have been reported among certain young populations in the U.S., as well as among Hispanic women and women in certain European countries. Young patients are significantly more likely to be female or Asian/Pacific Islander, have no tobacco use history, metastasis to the brain, and a higher frequency of somatic mutations or rearrangements. Diagnostic delays pose a considerable concern to young patients with lung cancer and may contribute to how these patients are more likely to be diagnosed with advanced disease than their older counterparts. However, young patients demonstrate improved survival compared to older patients, underscoring the importance of survivorship care. Young patients are more likely to be diagnosed at a disruptive time in their lives, rendering them with distinct psychosocial needs and financial toxicity. Future data on treatment-related effects on fertility and sexual health for young patients is warranted, as is the data related to complementary medicine use. Training in palliative care and promoting a positive attitude towards supportive care is also essential.
Young patients with lung cancer represent a distinct patient population, necessitating disease management that is markedly different from that of older patients with lung cancer. Future research, some of which are highlighted by this Review, will aid in elucidating risk factors, survival rates, and clinical, genomic, and histopathological characteristics of young-onset lung cancer to improve screening, early detection, prevention, and treatment of this understudied population.
年轻肺癌患者是一个独特的群体，具有独特的疾病及与治疗相关的特征，以及心理社会和生存需求。然而，这一群体仍未得到充分研究。
我们回顾了年轻肺癌患者独特的临床病理特征和需求，包括发病率、诊断挑战、基因组学、治疗模式与结局、心理社会需求、生育与性健康以及姑息治疗等主题。我们讨论了新出现和未充分研究的数据，对未来有必要开展研究的方面提出建议，并倡导多学科医疗团队可采用的可行策略，以提供更个性化和公平的护理。
尽管流行病学趋势表明所有年龄组的肺癌发病率总体呈下降趋势，但美国某些年轻人群以及西班牙裔女性和某些欧洲国家的女性中，近期报告的发病率有所上升。年轻患者更有可能为女性或亚裔/太平洋岛民，无吸烟史，发生脑转移，且体细胞突变或重排频率更高。诊断延迟是年轻肺癌患者相当关注的问题，可能导致这些患者比老年患者更易被诊断为晚期疾病。然而，与老年患者相比，年轻患者的生存率有所提高，这凸显了生存护理的重要性。年轻患者更有可能在其生活中的一个动荡时期被诊断出，这使其具有独特的心理社会需求和经济毒性。有必要获取关于年轻患者治疗对生育和性健康相关影响的未来数据，以及与补充医学使用相关的数据。姑息治疗培训和促进对支持性护理的积极态度也至关重要。
年轻肺癌患者代表了一个独特的患者群体，需要与老年肺癌患者明显不同的疾病管理方式。本综述所强调的一些未来研究，将有助于阐明年轻发病肺癌的危险因素、生存率以及临床、基因组和组织病理学特征，以改善对这一研究不足群体的筛查、早期检测、预防和治疗。
